Provider Demographics
NPI:1033169396
Name:COLELLA, FRANK JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:COLELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-2822
Mailing Address - Country:US
Mailing Address - Phone:570-883-2220
Mailing Address - Fax:570-883-1922
Practice Address - Street 1:200 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:WEST PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18643-2822
Practice Address - Country:US
Practice Address - Phone:570-883-2220
Practice Address - Fax:570-883-1922
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004645L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
674604Medicare ID - Type Unspecified