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General NPI Number Information
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NPI Number | 1184718066
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Entity Type | Organization
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Legal Business Name | DEFFIBAUGH CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 126 OSTER STREET
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City | OSTERBURG
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State | PA
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Zip | 16667
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Country | US
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Telephone | 814-276-3212
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Fax | 814-276-9253
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | OSTERBURG
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State | PA
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Zip | 16667-0487
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Country | US
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Telephone | 814-276-3212
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Fax | 814-276-9254
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Authorized Official
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Title or Position | PRESIDENT,/OWNER
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Name | DR. JOHN IRVIN DEFFIBAUGH III
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Credential | D.C.
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Telephone | 814-276-3212
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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 | DC003223L
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License Number State | PA
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