Provider Demographics
NPI:1124316229
Name:KUPCHELLA, JOSHUA PAUL (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PAUL
Last Name:KUPCHELLA
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 1:335 NEES AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-1239
Mailing Address - Country:US
Mailing Address - Phone:814-266-3226
Mailing Address - Fax:814-262-0656
Practice Address - Street 1:335 NEES AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-1239
Practice Address - Country:US
Practice Address - Phone:814-266-3226
Practice Address - Fax:814-262-0656
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor