Provider Demographics
NPI:1285727982
Name:VERNILLE, STEPHEN J (DC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:VERNILLE
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 1:21335 VALLEY FORGE CIR
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1122
Mailing Address - Country:US
Mailing Address - Phone:610-658-2001
Mailing Address - Fax:610-658-2703
Practice Address - Street 1:37 E WYNNEWOOD RD FL 2
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1917
Practice Address - Country:US
Practice Address - Phone:610-658-2001
Practice Address - Fax:610-658-2703
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005676L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA770012Medicare PIN