Provider Demographics
NPI:1912295692
Name:HANDS IN HEALTH, PC
Entity type:Organization
Organization Name:HANDS IN HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:L
Authorized Official - Last Name:DATRES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-916-5554
Mailing Address - Street 1:1730 BRISTOL AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3071
Mailing Address - Country:US
Mailing Address - Phone:570-916-5554
Mailing Address - Fax:570-329-2283
Practice Address - Street 1:1017 WASHINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3633
Practice Address - Country:US
Practice Address - Phone:570-916-5554
Practice Address - Fax:570-329-2283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010095111N00000X
PADC010094111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2147474OtherPENNSYLVANIA BLUE SHIELD
PA2147474OtherPENNSYLVANIA BLUE SHIELD