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General NPI Number Information
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NPI Number | 1205880416
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Entity Type | Organization
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Legal Business Name | AZZATORI CHIROPRACTIC OF WILLOW GROVE
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 612 FITZWATERTOWN RD
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1904
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Country | US
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Telephone | 215-830-6800
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Fax | 215-830-9712
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Provider Business Mailing Address
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Address Line | 612 FITZWATERTOWN RD
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1904
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Country | US
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Telephone | 215-830-6800
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Fax | 215-830-9712
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JENNIFER L YERKES
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Credential |
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Telephone | 215-538-2266
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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 | DC010543
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License Number State | PA
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