Levi Adam Koral, DSOM, L.OM

Individual provider Active NPI Acupuncturist · Forty Fort, PA

NPI 1962035212 · NPPES record last updated Feb 14, 2020

Key facts

NPI
1962035212
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
OM000275 (PA)
Practice address
900 Rutter Ave
Forty Fort, PA 18704-4962
Phone
(570) 262-1133
NPI assigned
Feb 14, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OM000275PAMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist
Group: 193400000X SINGLE SPECIALTY GROUP
171100000X OM000275 PA Yes

Addresses

Primary practice location

900 Rutter Ave
Forty Fort, PA 18704-4962

Mailing address

67 Butler St
Kingston, PA 18704-4720
Phone (570) 262-1133

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL levi@thekoralclinic.com Direct

Other providers in Forty Fort, PA

All providers in Forty Fort, PA · Acupuncturist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.