MEDICARE: DR. ALBERT SCOTT LAKERNICK 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	111NN0400X	Neurology Chiropractor	DC004519L	PA

General Provider Information

NPI Number	:	1447233747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT SCOTT LAKERNICK D.C.

Provider Business Mailing Address
First Line	:	625 CHESTER PIKE
Second Line	:
City	:	PROSPECT PARK
State	:	PA
Zip	:	19076-1506
Country	:	US
Telephone Number	:	610-534-4776
Fax Number	:	610-534-7245

Provider Business Practice Location Address
First Line	:	625 CHESTER PIKE
Second Line	:
City	:	PROSPECT PARK
State	:	PA
Zip	:	19076-1506
Country	:	US
Telephone Number	:	610-534-4776
Fax Number	:	610-534-7245

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	08/04/2010

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