Provider Demographics
NPI:1356306344
Name:SPERTZEL, JAMES DEAN (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DEAN
Last Name:SPERTZEL
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 1:23 N MAIN ST PO BOX 293
Mailing Address - Street 2:CHIROPRACTIC FITNESS CLINIC
Mailing Address - City:BIGLERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17307-9228
Mailing Address - Country:US
Mailing Address - Phone:717-677-6036
Mailing Address - Fax:717-677-9503
Practice Address - Street 1:23 N MAIN ST
Practice Address - Street 2:CHIROPRACTIC FITNESS CLINIC
Practice Address - City:BIGLERVILLE
Practice Address - State:PA
Practice Address - Zip Code:17307-9228
Practice Address - Country:US
Practice Address - Phone:717-677-6036
Practice Address - Fax:717-677-9503
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002642L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA441667OtherBLUE SHIELD
PA350006844OtherRR MEDICARE
PA01824401OtherCAPITAL BLU CROSS
PA441667OtherBLUE SHIELD
PA036912Medicare PIN