Healthcare Provider Details

I. General information

NPI: 1568190254
Provider Name (Legal Business Name): PITTSBURGH SPINE AND INJURY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3961 PERRYSVILLE AVE
PITTSBURGH PA
15214-1761
US

IV. Provider business mailing address

3961 PERRYSVILLE AVE
PITTSBURGH PA
15214-1761
US

V. Phone/Fax

Practice location:
  • Phone: 724-331-0312
  • Fax:
Mailing address:
  • Phone: 724-331-0312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT MOORE
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 724-331-0312