Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC002175-L | PA |
NPI | 1336323930 |
---|---|
Provider Name | Dr. Neal Lepovetsky |
First Address | Saint Marys, PA 15857-1708 |
Second Address | Saint Marys, PA 15857-1708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2007 |
Last Update Date | 19/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LE404693 | (02) | PA |