Healthcare Provider Details

I. General information

NPI: 1497889737
Provider Name (Legal Business Name): JR HELLER, DC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 BALTIMORE PIKE
SPRINGFIELD PA
19064-3071
US

IV. Provider business mailing address

616 BALTIMORE PIKE
SPRINGFIELD PA
19064-3071
US

V. Phone/Fax

Practice location:
  • Phone: 610-328-5111
  • Fax:
Mailing address:
  • Phone: 610-328-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MISS LYNDA GARY
Title or Position: MANAGER
Credential:
Phone: 610-328-5111