Provider Demographics
NPI:1598024408
Name:CHIROPRACTIC WELLNESS ASSOCIATES LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC WELLNESS ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:BERARDI
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:610-272-2272
Mailing Address - Street 1:1313 DEKALB ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3403
Mailing Address - Country:US
Mailing Address - Phone:610-272-2272
Mailing Address - Fax:610-279-1230
Practice Address - Street 1:1313 DEKALB ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3403
Practice Address - Country:US
Practice Address - Phone:610-272-2272
Practice Address - Fax:610-279-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty