Provider Demographics
NPI:1346805561
Name:AGASAR FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:AGASAR FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:AGASAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-550-6502
Mailing Address - Street 1:4 TERRY DR STE 12
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1882
Mailing Address - Country:US
Mailing Address - Phone:215-968-9000
Mailing Address - Fax:
Practice Address - Street 1:4 TERRY DR STE 12
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1882
Practice Address - Country:US
Practice Address - Phone:215-968-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty