Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC004738L | PA |
NPI | 1114029154 |
---|---|
Provider Name | Dr. Darryl Keef Warner |
First Address | Everett, PA 15537-7019 |
Second Address | Everett, PA 15537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 09/03/2016 |