Provider Demographics
NPI:1710533609
Name:CONKLE, CIERA J (DC)
Entity Type:Individual
Prefix:
First Name:CIERA
Middle Name:J
Last Name:CONKLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 BOYERTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-8907
Mailing Address - Country:US
Mailing Address - Phone:484-524-5318
Mailing Address - Fax:
Practice Address - Street 1:828 N HANOVER ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-4207
Practice Address - Country:US
Practice Address - Phone:484-524-5318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor