Provider Demographics
NPI:1144407388
Name:CAVALLO CHIROPRACTIC AND REHAB
Entity type:Organization
Organization Name:CAVALLO CHIROPRACTIC AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:N
Authorized Official - Last Name:SCARDUZIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-452-8003
Mailing Address - Street 1:1000 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-4234
Mailing Address - Country:US
Mailing Address - Phone:610-253-0611
Mailing Address - Fax:610-253-1816
Practice Address - Street 1:1000 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4234
Practice Address - Country:US
Practice Address - Phone:610-253-0611
Practice Address - Fax:610-253-1816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005766L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty