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General NPI Number Information
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NPI Number | 1104987098
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Entity Type | Organization
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Legal Business Name | DENISE PRIMAVERA D.C., P.C.
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4019 BETHLEHEM PIKE
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City | TELFORD
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State | PA
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Zip | 18969-1126
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Country | US
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Telephone | 215-723-7900
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Fax | 215-723-4481
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Provider Business Mailing Address
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Address Line | 4019 BETHLEHEM PIKE
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City | TELFORD
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State | PA
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Zip | 18969-1126
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Country | US
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Telephone | 215-723-7900
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Fax | 215-723-4481
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DENISE L. PRIMAVERA
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Credential | D.C.
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Telephone | 215-723-7900
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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 | DC005445L
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License Number State | PA
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