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General NPI Number Information
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NPI Number | 1497942130
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Entity Type | Individual
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Provider Name | DOUGLAS P LICHTINGER D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 212 HIGH STREET
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City | WATERFORD
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State | PA
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Zip | 16441
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Country | US
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Telephone | 814-796-9161
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Fax | 814-796-1211
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Provider Business Mailing Address
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Address Line | PO BOX 239
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City | WATERFORD
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State | PA
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Zip | 16441-0239
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Country | US
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Telephone | 814-796-9161
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Fax | 814-796-1211
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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 | DC007173L
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License Number State | PA
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