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General NPI Number Information
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NPI Number | 1558500355
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Entity Type | Organization
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Legal Business Name | COMPLETE HEALTH CHIROPRACTIC
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 10/09/2009
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Provider Practice Location Address
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Address Line | 1106 COCOA AVE
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City | HERSHEY
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State | PA
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Zip | 17033-1712
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Country | US
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Telephone | 717-979-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 1106 COCOA AVE
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City | HERSHEY
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State | PA
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Zip | 17033-1712
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Country | US
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Telephone | 717-520-1212
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | ROBIN K. MCCONNELL
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Credential | D.C.
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Telephone | 717-520-1212
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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 | DC008960
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License Number State | PA
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