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General NPI Number Information
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NPI Number | 1275837387
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Entity Type | Organization
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Legal Business Name | FAMILY TREE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 904 DAWN AVE
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City | EPHRATA
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State | PA
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Zip | 17522-1340
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Country | US
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Telephone | 717-738-2555
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Fax | 717-738-2557
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Provider Business Mailing Address
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Address Line | 904 DAWN AVE
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City | EPHRATA
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State | PA
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Zip | 17522-1340
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Country | US
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Telephone | 717-738-2555
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Fax | 717-738-2557
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID S PARKER
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Credential | D.C.
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Telephone | 717-738-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | DC003403L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | DC003403L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC003403L
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License Number State | PA
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