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General NPI Number Information
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NPI Number | 1619145422
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Entity Type | Organization
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Legal Business Name | DEPASQUA CHIROPRACTIC
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 305 MOUNT LEBANON BLVD SUITE 100
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City | PITTSBURGH
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State | PA
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Zip | 15234-1511
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Country | US
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Telephone | 412-531-4800
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Fax | 412-531-7788
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Provider Business Mailing Address
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Address Line | 1910 COCHRAN RD MANOR OAK ONE, SUITE 600
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City | PITTSBURGH
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State | PA
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Zip | 15220-1203
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Country | US
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Telephone | 412-563-8800
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Fax | 412-563-8319
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN C. DEPASQUA
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Credential | D.C.
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Telephone | 412-531-4800
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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 | DC007309L
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License Number State | PA
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