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General NPI Number Information
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NPI Number | 1639485931
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Entity Type | Organization
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Legal Business Name | CORE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 1124 GLENLIVET DR
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City | ALLENTOWN
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State | PA
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Zip | 18106-3104
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Country | US
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Telephone | 610-398-1610
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Fax | 610-398-1614
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Provider Business Mailing Address
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Address Line | 1124 GLENLIVET DR
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City | ALLENTOWN
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State | PA
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Zip | 18106-3104
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Country | US
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Telephone | 610-398-1610
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Fax | 610-398-1614
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ANGELA R NEWCOMER
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Credential | D.C.
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Telephone | 610-398-1610
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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 | DC009863
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License Number State | PA
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