Provider Demographics
NPI:1780737916
Name:GILES, KAREN J (DC)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:J
Last Name:GILES
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 1:68 LEE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18706-4015
Mailing Address - Country:US
Mailing Address - Phone:570-822-8254
Mailing Address - Fax:570-822-1876
Practice Address - Street 1:68 LEE PARK AVE
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-4015
Practice Address - Country:US
Practice Address - Phone:570-822-8254
Practice Address - Fax:570-822-1876
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007160L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGI535290OtherBLUE SHIELD
PA808858OtherFIRST PRIORITY HEALTH
PA0017387710002Medicaid
PA23-2988668OtherTAX ID#
PA23-2988668OtherTAX ID#
PAGI535290OtherBLUE SHIELD