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General NPI Number Information
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NPI Number | 1952810624
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Entity Type | Organization
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Legal Business Name | KLITSCH FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 2121 MAIN ST
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City | NORTHAMPTON
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State | PA
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Zip | 18067-1212
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Country | US
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Telephone | 610-262-8558
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Fax |
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Provider Business Mailing Address
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Address Line | 173 E MAIN ST
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City | MACUNGIE
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State | PA
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Zip | 18062-1310
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Country | US
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Telephone | 16104677559
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW KLITSCH
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Credential | DC
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Telephone | 610-216-8793
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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 | DC011289
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License Number State | PA
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