=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558485391
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHIROPRACTIC ASSOCIATES, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2007
-----------------------------------------------------
Last Update Date | 02/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 EAST MARKET STREET
-----------------------------------------------------
City | JONESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-865-6623
-----------------------------------------------------
Fax | 717-865-3382
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 657
-----------------------------------------------------
City | JONESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17038-0657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-865-6623
-----------------------------------------------------
Fax | 717-865-3382
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RICHARD E. OLFF
-----------------------------------------------------
Credential | D.C., F.A.C.O.
-----------------------------------------------------
Telephone | 717-865-6623
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC001466L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------