Organization
CONRAD CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER R CONRAD D.C. (OWNER)
(814) 886-9414
Entity
Organization
Contact information
Practice address
520 CHURCH ST, LILLY, PA 15938-1118
(814) 886-9414
(814) 886-9415
Mailing address
520 CHURCH ST, LILLY, PA 15938-1118
(814) 886-9414
(814) 886-9415
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC008957
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019523970001
—
PA
Enumeration date
01/06/2010
Last updated
01/06/2010
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