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General NPI Number Information
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NPI Number | 1205324654
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Entity Type | Organization
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Legal Business Name | DR. DAN MOSCHILLO, INC.
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 192 N BUHL FARM DR
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City | HERMITAGE
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State | PA
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Zip | 16148-1773
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Country | US
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Telephone | 724-347-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 192 N BUHL FARM DR
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City | HERMITAGE
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State | PA
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Zip | 16148-1773
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Country | US
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Telephone | 724-347-5125
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL JACK MOSCHILLO
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Credential | DO
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Telephone | 724-347-5125
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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 | DC008726
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License Number State | PA
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