Provider Demographics
NPI:1790141810
Name:FIEDLER CHIROPRACTIC PC
Entity Type:Organization
Organization Name:FIEDLER CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FIEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-742-8495
Mailing Address - Street 1:55 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:PA
Mailing Address - Zip Code:17847-1728
Mailing Address - Country:US
Mailing Address - Phone:570-742-8495
Mailing Address - Fax:570-713-1953
Practice Address - Street 1:55 CENTER ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:PA
Practice Address - Zip Code:17847-1728
Practice Address - Country:US
Practice Address - Phone:570-742-8495
Practice Address - Fax:570-713-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010371111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty