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General NPI Number Information
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NPI Number | 1023197365
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Entity Type | Individual
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Provider Name | ANDREW JOSEPH KRASHNAK III DC DACRB CCN DACBN
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 42 E MAIN ST
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City | PLYMOUTH
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State | PA
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Zip | 18651-0159
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Country | US
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Telephone | 570-779-4434
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Fax | 570-779-4439
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Provider Business Mailing Address
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Address Line | PO BOX 159 42 E MAIN ST
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City | PLYMOUTH
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State | PA
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Zip | 18651-0159
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Country | US
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Telephone | 570-779-4434
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Fax | 570-779-4439
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC4421L
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License Number State | PA
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