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Organization
SUSQUEHANNA SPINE & JOINT CENTER
Active
Organization
SUSQUEHANNA SPINE & JOINT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE KEITH STAKER D.C. (CHIROPRACTOR)
(717) 681-0198
Entity
Organization
Contact information
Practice address
46 S 18TH ST, COLUMBIA, PA 17512-9595
(717) 681-0198
(717) 681-0198
Mailing address
46 S 18TH ST, COLUMBIA, PA 17512-9595
(717) 681-0198
(717) 681-0198
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC009656
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101651583
—
PA
Enumeration date
02/16/2015
Last updated
04/15/2015
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