Provider Demographics
NPI:1497865596
Name:HILLER, CARL EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:EDWARD
Last Name:HILLER
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 1:100 ARRANDALE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2695
Mailing Address - Country:US
Mailing Address - Phone:610-594-5502
Mailing Address - Fax:610-594-1017
Practice Address - Street 1:100 ARRANDALE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2695
Practice Address - Country:US
Practice Address - Phone:610-594-5502
Practice Address - Fax:610-594-1017
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006088L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
788889QJFMedicare ID - Type Unspecified
U56793Medicare UPIN