Provider Demographics
NPI:1205128345
Name:HUGHES, KATY MECHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:KATY
Middle Name:MECHELLE
Last Name:HUGHES
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 1:40 BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-9202
Mailing Address - Country:US
Mailing Address - Phone:717-609-1333
Mailing Address - Fax:717-243-4986
Practice Address - Street 1:40 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9202
Practice Address - Country:US
Practice Address - Phone:717-609-1333
Practice Address - Fax:717-243-4986
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027245210001Medicaid