Healthcare Provider Details

I. General information

NPI: 1093778417
Provider Name (Legal Business Name): JOSEPH T. WUNDERLICH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2527 S QUEEN ST SUITE 7
YORK PA
17402-4965
US

IV. Provider business mailing address

2527 S QUEEN ST SUITE 7
YORK PA
17402-4965
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-1100
  • Fax: 717-741-1102
Mailing address:
  • Phone: 717-741-1100
  • Fax: 717-741-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC008758
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: