Provider Demographics
NPI:1407091929
Name:PERILLO CHIROPRACTIC LLP
Entity Type:Organization
Organization Name:PERILLO CHIROPRACTIC LLP
Other - Org Name:BE WELL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:PERILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-370-0860
Mailing Address - Street 1:PO BOX 20704
Mailing Address - Street 2:
Mailing Address - City:LEHIGH VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18002-0704
Mailing Address - Country:US
Mailing Address - Phone:610-317-9355
Mailing Address - Fax:610-317-9354
Practice Address - Street 1:2299 BRODHEAD RD
Practice Address - Street 2:STE A
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8908
Practice Address - Country:US
Practice Address - Phone:917-370-0860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA009889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty