Provider Demographics
NPI:1750322905
Name:AGASAR, JOSEPH R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:AGASAR
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 1:1400 W STREET RD
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3112
Mailing Address - Country:US
Mailing Address - Phone:215-675-1415
Mailing Address - Fax:215-675-8283
Practice Address - Street 1:1400 W STREET RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3112
Practice Address - Country:US
Practice Address - Phone:215-675-1415
Practice Address - Fax:215-675-8283
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002555L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0061123000OtherHMO
PA0061123000OtherHMO