Provider Demographics
NPI:1730458290
Name:DRUG TESTING CENTERS OF AMERICA-PENNSDALE
Entity Type:Organization
Organization Name:DRUG TESTING CENTERS OF AMERICA-PENNSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:TOON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-935-0342
Mailing Address - Street 1:21 KRISTI RD
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:PENNSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:17756-8427
Mailing Address - Country:US
Mailing Address - Phone:570-935-0342
Mailing Address - Fax:570-935-0328
Practice Address - Street 1:21 KRISTI RD
Practice Address - Street 2:SUITE 3B
Practice Address - City:PENNSDALE
Practice Address - State:PA
Practice Address - Zip Code:17756-8427
Practice Address - Country:US
Practice Address - Phone:570-935-0342
Practice Address - Fax:570-935-0328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009438111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty