Provider Demographics
NPI:1124598560
Name:NEW LEAF CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NEW LEAF CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BERARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-247-7621
Mailing Address - Street 1:1501 PAWLINGS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1437
Mailing Address - Country:US
Mailing Address - Phone:610-650-4500
Mailing Address - Fax:610-450-4501
Practice Address - Street 1:1501 PAWLINGS RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1437
Practice Address - Country:US
Practice Address - Phone:610-650-4500
Practice Address - Fax:610-450-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty