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General NPI Number Information
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NPI Number | 1255376547
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Entity Type | Individual
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Provider Name | M JONATHAN GARZILLO DC
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Gender | Male
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 108 E BEIDLER RD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1929
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Country | US
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Telephone | 610-337-7323
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Fax | 610-337-9662
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Provider Business Mailing Address
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Address Line | 108 E BEIDLER RD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1929
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Country | US
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Telephone | 610-337-7323
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Fax | 610-337-9662
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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 | DC004145-L
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License Number State | PA
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