Individual
DR. JACK K VANDERVORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
11581 STATE HWY 98, MEADVILLE, PA 16335-7321
(814) 336-3434
(814) 337-8767
Mailing address
11581 STATE HWY 98, MEADVILLE, PA 16335-7321
(814) 336-3434
(814) 337-8767
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC001577L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006316630002
—
PA
Enumeration date
04/13/2006
Last updated
04/14/2010
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