Provider Demographics
NPI:1811048523
Name:JARVIS, ANGELA L (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:L
Last Name:JARVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:206 MONROE ST
Mailing Address - Street 2:APT A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3309
Mailing Address - Country:US
Mailing Address - Phone:609-234-7442
Mailing Address - Fax:
Practice Address - Street 1:230 N MAPLE AVE STE G2
Practice Address - Street 2:HEALTH GOALS
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9415
Practice Address - Country:US
Practice Address - Phone:856-983-5422
Practice Address - Fax:856-983-6579
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00669400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor