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General NPI Number Information
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NPI Number | 1710024948
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Entity Type | Organization
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Legal Business Name | CICCARONE CHIROPRACTIC CARE CENTER, INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 144 E DEKALB PIKE SUITE 202
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2150
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Country | US
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Telephone | 610-337-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 144 E DEKALB PIKE SUITE 202
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2150
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Country | US
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Telephone | 610-337-3555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RITA ANNE CICCARONE
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Credential | DC
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Telephone | 610-337-3555
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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 | DC004075L
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License Number State | PA
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