Healthcare Provider Details

I. General information

NPI: 1740280700
Provider Name (Legal Business Name): ELLEN S JACKSON STROBEL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
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:
Title or Position:
Credential:
Phone: