Provider Demographics
NPI:1639179260
Name:AZZATORI, JOHN F (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:AZZATORI
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 1:594 S WEST END BLVD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1408
Mailing Address - Country:US
Mailing Address - Phone:215-538-2266
Mailing Address - Fax:215-538-2365
Practice Address - Street 1:594 S WEST END BLVD
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1408
Practice Address - Country:US
Practice Address - Phone:215-538-2266
Practice Address - Fax:215-538-2365
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006654L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA833408Medicare ID - Type UnspecifiedCHIROPRACTIC
PA833408Medicare UPIN