Provider Demographics
NPI:1538937008
Name:CANDELARIA TIRADO, DAVLINE MICHELLE (DC)
Entity type:Individual
Prefix:
First Name:DAVLINE
Middle Name:MICHELLE
Last Name:CANDELARIA TIRADO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NORTH UNION STREET
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-1950
Mailing Address - Country:US
Mailing Address - Phone:717-944-2225
Mailing Address - Fax:717-944-0932
Practice Address - Street 1:500 NORTH UNION STREET
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-1950
Practice Address - Country:US
Practice Address - Phone:717-944-2225
Practice Address - Fax:717-944-0932
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor