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General NPI Number Information
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NPI Number | 1134330509
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Entity Type | Organization
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Legal Business Name | CHESTNUT CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6239 SALTSBURG RD
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City | PITTSBURGH
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State | PA
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Zip | 15235-2067
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Country | US
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Telephone | 412-798-8138
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Fax |
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Provider Business Mailing Address
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Address Line | 6239 SALTSBURG RD
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City | PITTSBURGH
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State | PA
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Zip | 15235-2067
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Country | US
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Telephone | 412-798-8138
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER D. STOCK
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Credential |
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Telephone | 412-798-8138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC004611L
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License Number State | PA
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