Doctor Name: | DR. ANTHONY DEWALD |
NPI Number: | 1780084053 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | DC010975 |
Business Practice Address: | 15 N 5th St Lewisburg, PA - 178371407 |
Business Phone Number: | 5703378912 |
Business Fax Number: | |
Mailing Address: | 50 Sandra Lee Blvd, WEST MILTON |
State: | PA |
Postal Code: | 178869600 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/24/2014 |
NPI Last Update Date: | 12/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC010975 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |