Provider Demographics
NPI:1063550408
Name:CIRIO, ARDEL IGNACIO (DC)
Entity type:Individual
Prefix:DR
First Name:ARDEL
Middle Name:IGNACIO
Last Name:CIRIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BISHOP HOLLOW RD
Mailing Address - Street 2:SUITE A & C
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3228
Mailing Address - Country:US
Mailing Address - Phone:610-325-4200
Mailing Address - Fax:610-325-4272
Practice Address - Street 1:17 BISHOP HOLLOW RD
Practice Address - Street 2:SUITE A & C
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3228
Practice Address - Country:US
Practice Address - Phone:610-325-4200
Practice Address - Fax:610-325-4272
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004019-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0134140000OtherBX BS PERSONAL CHOICE