Provider Demographics
NPI:1609990365
Name:CHESTER COUNTY CHIROPRACTIC & WELLNESS,PC
Entity Type:Organization
Organization Name:CHESTER COUNTY CHIROPRACTIC & WELLNESS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-399-1400
Mailing Address - Street 1:PO BOX 1049
Mailing Address - Street 2:
Mailing Address - City:WESTTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19395-1049
Mailing Address - Country:US
Mailing Address - Phone:610-399-1400
Mailing Address - Fax:610-399-5040
Practice Address - Street 1:42-46 E STREET RD
Practice Address - Street 2:THE COMMONS AT THORNBURY
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382
Practice Address - Country:US
Practice Address - Phone:610-399-1400
Practice Address - Fax:610-399-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 004755L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA045827Medicare ID - Type UnspecifiedNUMBER USED WITH MEDICARE