Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0104556609 | VA |
Y | 111N00000X | Chiropractor | DC009867 | PA |
NPI | 1003010075 |
---|---|
Provider Name | Dr. William G Albert III |
First Address | New Milford, PA 18834-7431 |
Second Address | New Milford, PA 18834-7431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 03/07/2012 |