Healthcare Provider Details

I. General information

NPI: 1659816544
Provider Name (Legal Business Name): SOUTH HILLS PERFORMANCE CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2016
Last Update Date: 12/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 VANADIUM RD STE 307
PITTSBURGH PA
15243-1427
US

IV. Provider business mailing address

200 COWAN ST APT 216
PITTSBURGH PA
15211-1963
US

V. Phone/Fax

Practice location:
  • Phone: 740-317-3323
  • Fax:
Mailing address:
  • Phone: 740-317-3323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010591
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC010591
License Number StatePA

VIII. Authorized Official

Name: KEITH ZRINYI
Title or Position: DOCTOR/OWNER
Credential: DC
Phone: 740-317-3323