Provider Demographics
NPI:1295134823
Name:LEHIGH VALLEY INJURY & WELLNESS CENTER
Entity type:Organization
Organization Name:LEHIGH VALLEY INJURY & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:FELICIANO-FLATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-802-1768
Mailing Address - Street 1:37 W UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3934
Mailing Address - Country:US
Mailing Address - Phone:610-882-4000
Mailing Address - Fax:610-882-4008
Practice Address - Street 1:37 W UNION BLVD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-3934
Practice Address - Country:US
Practice Address - Phone:610-882-4000
Practice Address - Fax:610-882-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006857L111NR0400X
PAPT006125L261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty