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General NPI Number Information
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NPI Number | 1144719956
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Entity Type | Individual
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Provider Name | BYRON KANG FERNHOLZ DC
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Gender | Male
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 30 N VILLAGE AVE
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City | EXTON
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State | PA
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Zip | 19341-1211
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Country | US
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Telephone | 610-458-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 40 MARSHALL CIR
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2112
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Country | US
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Telephone | 484-571-7479
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Fax |
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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 | DC011374
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License Number State | PA
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