Healthcare Provider Details

I. General information

NPI: 1316261068
Provider Name (Legal Business Name): PLOUCHA CHIROPRACTIC CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1927 E CARSON ST
PITTSBURGH PA
15203-1835
US

IV. Provider business mailing address

1927 E CARSON ST
PITTSBURGH PA
15203-1835
US

V. Phone/Fax

Practice location:
  • Phone: 412-381-4422
  • Fax: 412-381-8503
Mailing address:
  • Phone: 412-381-4422
  • Fax: 412-381-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9443
License Number StatePA

VIII. Authorized Official

Name: DR. RONALD M PLOUCHA
Title or Position: CEO/CHIROPRACTOR
Credential: D.C.
Phone: 412-381-4422