Provider Demographics
NPI:1801776018
Name:BACCELLIERI CHIROPRACTIC
Entity type:Organization
Organization Name:BACCELLIERI CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:BACCELLIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:484-947-7019
Mailing Address - Street 1:2 WILLOW GREEN LN
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1765
Mailing Address - Country:US
Mailing Address - Phone:484-947-7019
Mailing Address - Fax:
Practice Address - Street 1:687 UNIONVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-4717
Practice Address - Country:US
Practice Address - Phone:610-444-2878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty