Provider Demographics
NPI:1114558269
Name:LINK, PAUL (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:LINK
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 1:416 W LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2818
Mailing Address - Country:US
Mailing Address - Phone:570-579-8784
Mailing Address - Fax:
Practice Address - Street 1:270 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2400
Practice Address - Country:US
Practice Address - Phone:570-579-8784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0001017111NN0400X
PADC011467111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty