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General NPI Number Information
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NPI Number | 1902549009
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Entity Type | Individual
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Provider Name | KEVIN CHARLES DOTTER DC
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Gender | Male
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Dates
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Enumeration Date | 04/16/2022
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 575 HORSHAM RD UNIT B11
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City | HORSHAM
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State | PA
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Zip | 19044-1760
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Country | US
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Telephone | 267-710-5683
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Fax |
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Provider Business Mailing Address
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Address Line | 8201 HENRY AVE APT S07
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City | PHILADELPHIA
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State | PA
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Zip | 19128-2258
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Country | US
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Telephone | 570-620-8482
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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 | DC011708
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License Number State | PA
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