Provider Demographics
NPI:1073696803
Name:DR. JAMES D. SPERTZEL
Entity Type:Organization
Organization Name:DR. JAMES D. SPERTZEL
Other - Org Name:CHIROPRACTIC FITNESS CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:SPERTZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-677-6036
Mailing Address - Street 1:23 NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIGLERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17307-9228
Mailing Address - Country:US
Mailing Address - Phone:717-677-6036
Mailing Address - Fax:717-677-9503
Practice Address - Street 1:23 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:BIGLERVILLE
Practice Address - State:PA
Practice Address - Zip Code:17307-9228
Practice Address - Country:US
Practice Address - Phone:717-677-6036
Practice Address - Fax:717-677-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002642L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01824401OtherBLUE CROSS
PA441667OtherHIGHMARK BLUE SHIELD
PA441667OtherHIGHMARK BLUE SHIELD