Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC001664L | PA |
N | 111NS0005X | Chiropractic Sports Physician | DC001664L | PA |
N | 111NX0100X | Occupational Health | DC001664L | PA |
NPI | 1346332871 |
---|---|
Provider Name | Dr. Michael Gordon Appleby |
First Address | Harrisburg, PA 17103-1769 |
Second Address | Harrisburg, PA 17103-1769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07629317 | (05) | PA |
A05951 | STATE LICENSE [INACTIVE] (01) | IA |
DC001664L | STATE LICENSE (01) | PA |
T72672 | (02) | PA |