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General NPI Number Information
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NPI Number | 1255887394
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Entity Type | Organization
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Legal Business Name | SKELETONEX CHIROPRACTIC & REHABILITATION, INC
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 927 W HIGH ST STE 5
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City | EBENSBURG
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State | PA
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Zip | 15931-1856
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Country | US
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Telephone | 814-419-8277
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Fax | 814-419-8285
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Provider Business Mailing Address
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Address Line | 927 W HIGH ST STE 5
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City | EBENSBURG
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State | PA
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Zip | 15931-1856
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Country | US
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Telephone | 814-419-8277
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Fax | 814-419-8285
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BRIANNE MARIE LEICHLITER
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Credential |
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Telephone | 814-419-8277
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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 | DC011159
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License Number State | PA
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