Provider Demographics
NPI:1053512640
Name:JOSEPH T. DE CARLO, D.C.
Entity Type:Organization
Organization Name:JOSEPH T. DE CARLO, D.C.
Other - Org Name:DE CARLO ENTERPRISES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:DE CARLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:215-860-6047
Mailing Address - Street 1:123 SWALLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1953
Mailing Address - Country:US
Mailing Address - Phone:215-860-6047
Mailing Address - Fax:215-322-7551
Practice Address - Street 1:207 PENNS TRAIL
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-860-6047
Practice Address - Fax:215-322-7551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-003441-L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty