Healthcare Provider Details

I. General information

NPI: 1134256373
Provider Name (Legal Business Name): HENRY WILLIAM BILDER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 LUZERNE AVE SUITE 160
WEST PITTSTON PA
18643-2817
US

IV. Provider business mailing address

16 LUZERNE AVE SUITE 160
WEST PITTSTON PA
18643-2817
US

V. Phone/Fax

Practice location:
  • Phone: 570-655-8400
  • Fax: 570-655-8420
Mailing address:
  • Phone: 570-655-8400
  • Fax: 570-655-8420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009275
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: