Provider Demographics
NPI:1083911176
Name:DI CARLO, ANGELO (DC)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:
Last Name:DI CARLO
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 1:4955 ROUTE 873
Mailing Address - Street 2:SUITE E
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2268
Mailing Address - Country:US
Mailing Address - Phone:610-799-4060
Mailing Address - Fax:610-799-4011
Practice Address - Street 1:4955 ROUTE 873
Practice Address - Street 2:SUITE E
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2268
Practice Address - Country:US
Practice Address - Phone:610-799-4060
Practice Address - Fax:610-799-4011
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor