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General NPI Number Information
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NPI Number | 1124143664
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Entity Type | Organization
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Legal Business Name | KONDNER CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 120 BROADWAY
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City | HANOVER
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State | PA
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Zip | 17331-2513
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Country | US
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Telephone | 717-630-9292
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Fax | 717-630-0488
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Provider Business Mailing Address
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Address Line | 120 BROADWAY
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City | HANOVER
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State | PA
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Zip | 17331-2513
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Country | US
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Telephone | 717-630-9292
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Fax | 717-630-0488
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS KONDNER
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Credential |
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Telephone | 717-630-9292
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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 | DC004797-L
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License Number State | PA
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