Healthcare Provider Details

I. General information

NPI: 1609990365
Provider Name (Legal Business Name): CHESTER COUNTY CHIROPRACTIC & WELLNESS,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42-46 E STREET RD THE COMMONS AT THORNBURY
WEST CHESTER PA
19382
US

IV. Provider business mailing address

PO BOX 1049
WESTTOWN PA
19395-1049
US

V. Phone/Fax

Practice location:
  • Phone: 610-399-1400
  • Fax: 610-399-5040
Mailing address:
  • Phone: 610-399-1400
  • Fax: 610-399-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC 004755L
License Number StatePA

VIII. Authorized Official

Name: DR. JOHN T WOODWARD
Title or Position: PRESIDENT
Credential: D.C.
Phone: 610-399-1400