MEDICARE: PAUL MARK HASTIE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC001465L	PA

General Provider Information

NPI Number	:	1225199425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL MARK HASTIE D.C.

Provider Business Mailing Address
First Line	:	2830 CONCORD RD
Second Line	:
City	:	ASTON
State	:	PA
Zip	:	19014-2946
Country	:	US
Telephone Number	:	610-497-2779
Fax Number	:

Provider Business Practice Location Address
First Line	:	2830 CONCORD RD
Second Line	:
City	:	ASTON
State	:	PA
Zip	:	19014-2946
Country	:	US
Telephone Number	:	610-497-2779
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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Directions to “ PAUL MARK HASTIE D.C.” Practice Location

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