Provider Demographics
NPI:1679633978
Name:SUGLIA, PATRICK VINCENT (DC, CRT)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:VINCENT
Last Name:SUGLIA
Suffix:
Gender:M
Credentials:DC, CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 POTTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:SHOEMAKERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19555-1721
Mailing Address - Country:US
Mailing Address - Phone:484-665-2303
Mailing Address - Fax:484-575-9213
Practice Address - Street 1:1383 POTTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:SHOEMAKERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19555-1721
Practice Address - Country:US
Practice Address - Phone:484-665-2303
Practice Address - Fax:484-575-9213
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374K00000X, 101YP1600X
PADC007851L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral