Provider Demographics
NPI:1174797823
Name:GUINOSSO, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:GUINOSSO
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 1:123 N SYCAMORE ST
Mailing Address - Street 2:SUITE A3
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1512
Mailing Address - Country:US
Mailing Address - Phone:267-980-3339
Mailing Address - Fax:
Practice Address - Street 1:123 N SYCAMORE ST
Practice Address - Street 2:SUITE A3
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1512
Practice Address - Country:US
Practice Address - Phone:267-980-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007691-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor