Provider Demographics
NPI:1780733238
Name:GARABO, CHARLES PAUL JR (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PAUL
Last Name:GARABO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:114 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-4697
Mailing Address - Country:US
Mailing Address - Phone:610-433-3300
Mailing Address - Fax:610-433-3803
Practice Address - Street 1:114 N 13TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-4697
Practice Address - Country:US
Practice Address - Phone:610-433-3300
Practice Address - Fax:610-433-3803
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007476L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU77617Medicare UPIN