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General NPI Number Information
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NPI Number | 1750893301
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Entity Type | Organization
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Legal Business Name | REPPERT CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 4651 COLEBROOK AVE
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City | EMMAUS
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State | PA
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Zip | 18049-1028
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Country | US
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Telephone | 484-515-6371
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Fax |
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Provider Business Mailing Address
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Address Line | 4251 OAKLEIGH RD
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City | ALLENTOWN
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State | PA
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Zip | 18104-4419
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Country | US
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Telephone | 484-515-6371
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW CHRISTOPHER REPPERT
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Credential | DC
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Telephone | 484-515-6371
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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 | DC010577
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License Number State | PA
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