Individual
GARY LEE PAGENKOPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
14603 RIDGE RD, WEST SPRINGFIELD, PA 16443-1631
(814) 922-3800
(814) 922-7706
Mailing address
14603 RIDGE RD, PO BOX 102, WEST SPRINGFIELD, PA 16443-1631
(814) 922-3800
(814) 922-7706
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-002428-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008625260001
—
PA
05
—
0492293
—
OH
01
—
0662096
AETNA
PA
01
—
104767
HIGHMARK INDIVIDUAL
PA
05
—
1500250
—
PA
05
—
153721
—
PA
01
—
210837
UPMC
PA
01
—
232382179-00
OHIO WORKER'S COMPENSATIO
OH
01
—
4644065
AETNA
PA
01
—
6667738
CIGNA
PA
01
—
714767
HIGHMARK
PA
Enumeration date
09/02/2005
Last updated
07/09/2007
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