Provider Demographics
NPI:1245413749
Name:DANIEL T. WEST PC
Entity Type:Organization
Organization Name:DANIEL T. WEST PC
Other - Org Name:EAST EARL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-354-2332
Mailing Address - Street 1:4607 DIVISION HWY
Mailing Address - Street 2:
Mailing Address - City:EAST EARL
Mailing Address - State:PA
Mailing Address - Zip Code:17519-9245
Mailing Address - Country:US
Mailing Address - Phone:717-354-2332
Mailing Address - Fax:
Practice Address - Street 1:4607 DIVISION HWY
Practice Address - Street 2:
Practice Address - City:EAST EARL
Practice Address - State:PA
Practice Address - Zip Code:17519-9245
Practice Address - Country:US
Practice Address - Phone:717-354-2332
Practice Address - Fax:717-355-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-0038100111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU11414Medicare UPIN
PA541292Medicare PIN