=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962539460
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANK E. DEL SANDRO,D.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1123 W 38TH ST
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16508-2457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-868-7536
-----------------------------------------------------
Fax | 814-868-9888
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1123 W 38TH ST
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16508-2457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-868-7536
-----------------------------------------------------
Fax | 814-868-9888
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | FRANK EDWARD DEL SANDRO
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 814-868-7536
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC003190L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------