| NPI | 1558564039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY A BACKENTSTOE Billing Agent 610-751-1289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC006650L) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |