Provider Demographics
NPI:1801090139
Name:SYNERGY CHIROPRACTIC WELLNESS
Entity type:Organization
Organization Name:SYNERGY CHIROPRACTIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:484-775-0550
Mailing Address - Street 1:98 WILMINGTON W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9029
Mailing Address - Country:US
Mailing Address - Phone:484-775-0550
Mailing Address - Fax:484-840-0100
Practice Address - Street 1:98 WILMINGTON W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9029
Practice Address - Country:US
Practice Address - Phone:484-775-0550
Practice Address - Fax:484-840-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010288111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1134162076OtherINDIVIDUAL NPI NUMBER
DE1134162076OtherINDIVIDUAL NPI NUMBER