Healthcare Provider Details

I. General information

NPI: 1851363683
Provider Name (Legal Business Name): MT. LEBANON CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 BEVERLY RD
PITTSBURGH PA
15216-1548
US

IV. Provider business mailing address

396 BEVERLY RD
PITTSBURGH PA
15216-1548
US

V. Phone/Fax

Practice location:
  • Phone: 412-561-4447
  • Fax: 412-561-6371
Mailing address:
  • Phone: 412-561-4447
  • Fax: 412-561-6371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-5760-L
License Number StatePA

VIII. Authorized Official

Name: DR. ERIC JAY AUSLANDER
Title or Position: PRESIDENT
Credential: DC
Phone: 412-561-4447