Healthcare Provider Details

I. General information

NPI: 1386989739
Provider Name (Legal Business Name): TRANSITIONDC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 BRIDGEPORT ST
MT PLEASANT PA
15666-2034
US

IV. Provider business mailing address

217 BRIDGEPORT ST
MT PLEASANT PA
15666-2034
US

V. Phone/Fax

Practice location:
  • Phone: 724-547-7513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010485
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberDC010485
License Number StatePA

VIII. Authorized Official

Name: KAREN JORGENSEN
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 817-917-9648