Provider Demographics
NPI:1366472334
Name:FIELDS CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:FIELDS CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-228-1330
Mailing Address - Street 1:536 E PENN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEONA
Mailing Address - State:PA
Mailing Address - Zip Code:17042-2551
Mailing Address - Country:US
Mailing Address - Phone:717-228-1330
Mailing Address - Fax:717-228-1334
Practice Address - Street 1:536 E PENN AVE
Practice Address - Street 2:
Practice Address - City:CLEONA
Practice Address - State:PA
Practice Address - Zip Code:17042-2551
Practice Address - Country:US
Practice Address - Phone:717-228-1330
Practice Address - Fax:717-228-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005321-L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty