Provider Demographics
NPI:1689981292
Name:SUNBURY SPINE & JOINT INSTITUTE
Entity Type:Organization
Organization Name:SUNBURY SPINE & JOINT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-594-5502
Mailing Address - Street 1:760 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2547
Mailing Address - Country:US
Mailing Address - Phone:610-594-5502
Mailing Address - Fax:610-594-1017
Practice Address - Street 1:2 ATRIUM CT
Practice Address - Street 2:STE B
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-9019
Practice Address - Country:US
Practice Address - Phone:570-991-6376
Practice Address - Fax:570-991-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007285L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU70739Medicare UPIN
PA057178Medicare PIN