Healthcare Provider Details

I. General information

NPI: 1003860149
Provider Name (Legal Business Name): SEXTON FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 2ND STREET PIKE
SOUTHAMPTON PA
18966-3948
US

IV. Provider business mailing address

779 2ND STREET PIKE
SOUTHAMPTON PA
18966-3948
US

V. Phone/Fax

Practice location:
  • Phone: 215-322-9989
  • Fax: 215-322-0948
Mailing address:
  • Phone: 215-322-9989
  • Fax: 215-322-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-007556-L
License Number StatePA

VIII. Authorized Official

Name: DR. GRANT JOSEPH SEXTON
Title or Position: OWNER
Credential: D.C.
Phone: 215-322-9989