MEDICARE: DR. JOSEPH B CANTWELL DC

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	DC009367	PA

General Provider Information

NPI Number	:	1417942756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH B CANTWELL DC

Provider Business Mailing Address
First Line	:	112 SCHOOL LN
Second Line	:
City	:	TELFORD
State	:	PA
Zip	:	18969-2043
Country	:	US
Telephone Number	:	215-721-3998
Fax Number	:	215-721-3990

Provider Business Practice Location Address
First Line	:	112 SCHOOL LN
Second Line	:
City	:	TELFORD
State	:	PA
Zip	:	18969-2043
Country	:	US
Telephone Number	:	215-721-3998
Fax Number	:	215-721-3990

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	07/08/2007

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