Healthcare Provider Details

I. General information

NPI: 1518769694
Provider Name (Legal Business Name): ALTAVILLA CHIROPRACTIC AND SPORTS RECOVERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 E MCMURRAY RD STE B
MC MURRAY PA
15317-2948
US

IV. Provider business mailing address

228 E MCMURRAY RD STE B
MC MURRAY PA
15317-2948
US

V. Phone/Fax

Practice location:
  • Phone: 412-855-9884
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NICHOLAS R ALTAVILLA
Title or Position: PRESIDENT
Credential: DC
Phone: 412-855-9884