Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC002247L | PA |
NPI | 1245458785 |
---|---|
Provider Name | Dr. Louis R. Simek |
First Address | Export, PA 15632-9214 |
Second Address | Pittsburgh, PA 15235-5511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
150065 | (02) | PA |