Healthcare Provider Details

I. General information

NPI: 1407814684
Provider Name (Legal Business Name): CARING CHIROPRACTIC SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7870 W RIDGE RD SUITE 3
FAIRVIEW PA
16415-1808
US

IV. Provider business mailing address

PO BOX 914 7870 WEST RIDGE RD STE 3
FAIRVIEW PA
16415-0914
US

V. Phone/Fax

Practice location:
  • Phone: 814-474-3446
  • Fax: 814-474-2535
Mailing address:
  • Phone: 814-474-3446
  • Fax: 814-474-2535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007701L
License Number StatePA

VIII. Authorized Official

Name: ELLEN S JACKSON
Title or Position: PRESIDENT
Credential: D.C.
Phone: 814-474-3446