Provider Demographics
NPI:1578771143
Name:CULBERTSON, HARRY EDWARD III (BSDC)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:EDWARD
Last Name:CULBERTSON
Suffix:III
Gender:M
Credentials:BSDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-3269
Mailing Address - Country:US
Mailing Address - Phone:610-696-2274
Mailing Address - Fax:
Practice Address - Street 1:120 S HIGH ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-3269
Practice Address - Country:US
Practice Address - Phone:610-696-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004646L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACU020005Medicare ID - Type Unspecified
PAU35013Medicare UPIN