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General NPI Number Information
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NPI Number | 1609108778
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Entity Type | Organization
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Legal Business Name | GONSTEAD FAMILY CHIROPRACTIC OF FRANKLIN, LLC
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 324 13TH ST
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City | FRANKLIN
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State | PA
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Zip | 16323-1367
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Country | US
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Telephone | 814-437-2210
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Fax | 814-437-2105
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Provider Business Mailing Address
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Address Line | 1261 S MAIN ST
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City | MEADVILLE
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State | PA
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Zip | 16335-3034
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Country | US
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Telephone | 814-336-5420
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Fax | 814-336-2898
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN D JACKSON
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Credential | D.C.
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Telephone | 814-437-2210
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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 |
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License Number State |
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