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General NPI Number Information
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NPI Number | 1922418722
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Entity Type | Organization
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Legal Business Name | SACK FAMILY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 163 S GREEN ST
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City | NAZARETH
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State | PA
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Zip | 18064-2014
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Country | US
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Telephone | 610-759-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 163 S GREEN ST
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City | NAZARETH
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State | PA
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Zip | 18064-2014
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Country | US
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Telephone | 610-759-0500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DREW SACK
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Credential | D.C.
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Telephone | 484-619-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC009693
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License Number State | PA
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