Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC010909 | PA |
NPI | 1003219437 |
---|---|
Provider Name | Dr. Pranav Halvawala |
First Address | Bensalem, PA 19020-3569 |
Second Address | Bensalem, PA 19020-3569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2014 |
Last Update Date | 24/10/2014 |