Organization
CHIROEVOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORA ALYCE GENTRY FOGEL DC (CO OWNER)
(412) 228-0373
Entity
Organization
Contact information
Practice address
1001 WEXFORD PLAZA DR, WEXFORD, PA 15090-9214
(412) 228-0373
Mailing address
1001 WEXFORD PLAZA DR, WEXFORD, PA 15090-9214
(412) 228-0373
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC011060
PA
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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