Provider Demographics
NPI:1023188117
Name:FITCHETT CHIROPRACTIC CENTER, PC
Entity Type:Organization
Organization Name:FITCHETT CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-444-2878
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-0207
Mailing Address - Country:US
Mailing Address - Phone:610-444-2878
Mailing Address - Fax:610-444-3953
Practice Address - Street 1:685 UNIONVILLE RD
Practice Address - Street 2:SUITE #1
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1736
Practice Address - Country:US
Practice Address - Phone:610-444-2878
Practice Address - Fax:610-444-3953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003763, DC009692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0861426000OtherBCBS, KEYSTONE, AMERIHEAL
PA=========OtherTAXID