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Individual

DR. DAVID JAMES LIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
111 E MAIN ST, UNIONTOWN, PA 15401-3607
(724) 437-9020
(724) 437-0295
Mailing address
111 E MAIN ST, UNIONTOWN, PA 15401-3607
(724) 437-9020
(724) 437-0295

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4928L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043386
WV WC VENDOR NUMBER
WV
01
1539534
GATEWAY PROVIDER NUMBER
PA
05
1619126
PA
01
351224
BCBS GROUP NUMBER
PA
Enumeration date
05/21/2007
Last updated
07/08/2007
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