Provider Demographics
NPI:1093953317
Name:RIEHL, JESSICA KATHLEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:KATHLEEN
Last Name:RIEHL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CENTER STREET
Mailing Address - Street 2:PO BOX 67
Mailing Address - City:INTERCOURSE
Mailing Address - State:PA
Mailing Address - Zip Code:17534
Mailing Address - Country:US
Mailing Address - Phone:717-768-7148
Mailing Address - Fax:717-768-7149
Practice Address - Street 1:7 CENTER STREET
Practice Address - Street 2:
Practice Address - City:INTERCOURSE
Practice Address - State:PA
Practice Address - Zip Code:17534-0000
Practice Address - Country:US
Practice Address - Phone:717-768-7148
Practice Address - Fax:717-768-7149
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor