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General NPI Number Information
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NPI Number | 1770104341
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Entity Type | Individual
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Provider Name | DR. NICHOLAS PABLES
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Gender | Male
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 3038 BUTLER PIKE
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-2115
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Country | US
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Telephone | 610-940-6756
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Fax |
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Provider Business Mailing Address
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Address Line | 12001 TEMPLETON DR
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City | PHILADELPHIA
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State | PA
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Zip | 19154-2721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC011549
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License Number State | PA
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