Healthcare Provider Details

I. General information

NPI: 1396766085
Provider Name (Legal Business Name): ATLAS CHIROPRACTIC OF WYOMISSING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 WINDMILL RD SUITE 4
SINKING SPRING PA
19608-1679
US

IV. Provider business mailing address

2917 WINDMILL RD SUITE 4
SINKING SPRING PA
19608-1679
US

V. Phone/Fax

Practice location:
  • Phone: 610-685-8527
  • Fax:
Mailing address:
  • Phone: 610-685-8527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007924L
License Number StatePA

VIII. Authorized Official

Name: DR. MARC ANTHONY CALICCHIO
Title or Position: OWNER
Credential: D.C.
Phone: 610-685-8527