Provider Demographics
NPI:1578727186
Name:INGOLDSBY, CHARLES B (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:B
Last Name:INGOLDSBY
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 1:2878 FREEPORT RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1906
Mailing Address - Country:US
Mailing Address - Phone:724-448-9542
Mailing Address - Fax:
Practice Address - Street 1:2878 FREEPORT RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1906
Practice Address - Country:US
Practice Address - Phone:724-448-9542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-12
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor