Provider Demographics
NPI:1568586402
Name:FRENCH, JONATHAN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:FRENCH
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 1:79 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:NEWMANSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17073-9110
Mailing Address - Country:US
Mailing Address - Phone:610-504-8806
Mailing Address - Fax:
Practice Address - Street 1:2101 MACK BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-5685
Practice Address - Country:US
Practice Address - Phone:610-507-8806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004474L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA667168Medicare ID - Type Unspecified
PAU17545Medicare UPIN