Organization
JENIFER L. DEWALD, DC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENIFER LYNN DEWALD DO (PRESIDENT)
(570) 322-1776
Entity
Organization
Contact information
Practice address
1355 FOUR MILE DR, WILLIAMSPORT, PA 17701-1932
(570) 322-1776
(570) 322-1774
Mailing address
1355 FOUR MILE DR, WILLIAMSPORT, PA 17701-1932
(570) 322-1776
(570) 322-1774
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017404480002
—
PA
Enumeration date
07/05/2006
Last updated
07/25/2007
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