Provider Demographics
NPI:1376683565
Name:HENLOPEN CHIROPRACTIC CENTER PA INC
Entity Type:Organization
Organization Name:HENLOPEN CHIROPRACTIC CENTER PA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-644-1420
Mailing Address - Street 1:P.O. BOX 40450
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-0450
Mailing Address - Country:US
Mailing Address - Phone:440-871-4700
Mailing Address - Fax:440-871-4702
Practice Address - Street 1:1520 SAVANNAH RD
Practice Address - Street 2:STE 2
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1624
Practice Address - Country:US
Practice Address - Phone:302-644-1420
Practice Address - Fax:302-645-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEUPN 177OtherBLUE CROSS BLUE SHIELD
DEH014418Medicare ID - Type Unspecified
DE757932Medicare ID - Type Unspecified
W82195Medicare UPIN