Individual
DR. ANDREW PAUL LATANISHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4233 OREGON PIKE, EPHRATA, PA 17522-9450
(717) 859-4222
(717) 859-1562
Mailing address
4233 OREGON PIKE, EPHRATA, PA 17522-9450
(717) 859-4222
(717) 859-1562
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC003612
PA
111NR0200X
Radiology Chiropractor
DC003612
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105553D5E
RENDERING PROVIDER
PA
Enumeration date
07/29/2005
Last updated
03/11/2008
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