Provider Demographics
NPI:1518206457
Name:DECARLO ENTERPRISES LLC
Entity Type:Organization
Organization Name:DECARLO ENTERPRISES LLC
Other - Org Name:JOSEPH T. DE CARLO, D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DE CARLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-364-1331
Mailing Address - Street 1:123 SWALLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1953
Mailing Address - Country:US
Mailing Address - Phone:215-364-1331
Mailing Address - Fax:215-322-7551
Practice Address - Street 1:829 SECOND STREET PIKE
Practice Address - Street 2:BLDG. B
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1067
Practice Address - Country:US
Practice Address - Phone:215-364-1331
Practice Address - Fax:215-322-7551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-003441-L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty