=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336641737
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STANGL CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2018
-----------------------------------------------------
Last Update Date | 03/02/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 933 N 4TH ST
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18102-1852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-434-7562
-----------------------------------------------------
Fax | 484-221-9171
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 933 N 4TH ST
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18102-1852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-434-7562
-----------------------------------------------------
Fax | 484-221-9171
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. ALAN STANGL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 610-434-7562
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number | DC003419L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------