Provider Demographics
NPI:1689615932
Name:BUCKS COUNTY WELLNESS CENTRE
Entity Type:Organization
Organization Name:BUCKS COUNTY WELLNESS CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:DONOHUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-968-1661
Mailing Address - Street 1:121 FRIENDS LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1897
Mailing Address - Country:US
Mailing Address - Phone:215-968-1661
Mailing Address - Fax:215-968-7722
Practice Address - Street 1:121 FRIENDS LN
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1897
Practice Address - Country:US
Practice Address - Phone:215-968-1661
Practice Address - Fax:215-968-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004895L111N00000X
PADC006966L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0482885000OtherIBC
PA386302OtherHIGHMARK
PA0482885000OtherIBC
U35716Medicare UPIN