Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC009562 | PA |
NPI | 1003947763 |
---|---|
Provider Name | Dr. Christine K. Maclary |
First Address | Lititz, PA 17543-2602 |
Second Address | Lititz, PA 17543-2602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V08840 | (02) | PA |