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General NPI Number Information
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NPI Number | 1306599527
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Entity Type | Organization
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Legal Business Name | ORIGINS CHIROPRACTIC AND WELLNESS
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 50 ABELE RD STE 1003
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-3442
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Country | US
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Telephone | 412-998-9966
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Fax | 412-744-3091
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Provider Business Mailing Address
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Address Line | 50 ABELE RD STE 1003
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-3442
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Country | US
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Telephone | 412-998-9966
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Fax | 412-744-3091
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/ SECRETARY
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Name | DR. KYNAN TARNOWSKI
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Credential | DC
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Telephone | 412-998-9966
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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 |
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License Number State |
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