Provider Demographics
NPI:1194255414
Name:PITCEL, EMERY VAUGHN (DC)
Entity type:Individual
Prefix:
First Name:EMERY
Middle Name:VAUGHN
Last Name:PITCEL
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 1:138 W WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5931
Mailing Address - Country:US
Mailing Address - Phone:586-255-9170
Mailing Address - Fax:
Practice Address - Street 1:1402 S ATHERTON ST STE 204
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6255
Practice Address - Country:US
Practice Address - Phone:814-441-5532
Practice Address - Fax:814-556-2110
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013115111N00000X
PADC011569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor