Provider Demographics
NPI:1740281823
Name:GILLESPIE, JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:GILLESPIE
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 1:1452 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4658
Mailing Address - Country:US
Mailing Address - Phone:215-322-8480
Mailing Address - Fax:215-322-2474
Practice Address - Street 1:1452 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4658
Practice Address - Country:US
Practice Address - Phone:215-322-8480
Practice Address - Fax:215-322-2474
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007762L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U87184Medicare UPIN
PA051570Medicare ID - Type Unspecified