Healthcare Provider Details

I. General information

NPI: 1538345715
Provider Name (Legal Business Name): LIFESTYLE FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 WASHINGTON RD SUIT 318 DONALDSON'S CROSSROADS PLAZA
MC MURRAY PA
15317-2544
US

IV. Provider business mailing address

3909 WASHINGTON RD SUIT 318 DONALDSON'S CROSSROADS PLAZA
MC MURRAY PA
15317-2544
US

V. Phone/Fax

Practice location:
  • Phone: 724-969-0800
  • Fax:
Mailing address:
  • Phone: 724-969-0800
  • 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. MICHAEL E HANLON
Title or Position: OWNER
Credential: D.C.
Phone: 724-628-2504