Provider Demographics
NPI:1194760306
Name:HUERTGEN, NORMAN R (DC)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:R
Last Name:HUERTGEN
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 1:711 BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:ERDENHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8114
Mailing Address - Country:US
Mailing Address - Phone:215-233-6880
Mailing Address - Fax:215-233-2876
Practice Address - Street 1:711 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:ERDENHEIM
Practice Address - State:PA
Practice Address - Zip Code:19038-8114
Practice Address - Country:US
Practice Address - Phone:215-233-6880
Practice Address - Fax:215-233-2876
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005334L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2244608000OtherIBC
PA1562279OtherBS
PA1562279OtherBS
PA164495Medicare ID - Type Unspecified