Organization
RADIANCE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA COUGHLIN DC (OWNER/CHIROPRACTOR)
(610) 688-3336
Entity
Organization
Contact information
Practice address
240 CONESTOGA RD, WAYNE, PA 19087-4748
(610) 688-3336
Mailing address
240 CONESTOGA RD, WAYNE, PA 19087-4748
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3630520
AETNA HMO
—
Enumeration date
07/29/2006
Last updated
08/22/2020
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