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General NPI Number Information
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NPI Number | 1124598560
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Entity Type | Organization
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Legal Business Name | NEW LEAF CHIROPRACTIC LLC
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 1501 PAWLINGS RD
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-1437
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Country | US
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Telephone | 610-650-4500
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Fax | 610-450-4501
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Provider Business Mailing Address
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Address Line | 1501 PAWLINGS RD
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-1437
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Country | US
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Telephone | 610-650-4500
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Fax | 610-450-4501
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW BERARDI
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Credential |
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Telephone | 610-247-7621
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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 |
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License Number State |
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