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General NPI Number Information
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NPI Number | 1740512029
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Entity Type | Organization
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Legal Business Name | RIVER OF LIFE CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 2104 ZIMMERLY RD
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City | ERIE
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State | PA
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Zip | 16509-6213
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Country | US
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Telephone | 814-866-2277
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Fax | 814-866-0167
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Provider Business Mailing Address
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Address Line | 2104 ZIMMERLY RD
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City | ERIE
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State | PA
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Zip | 16509-6213
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Country | US
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Telephone | 814-866-2277
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Fax | 814-866-0167
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TIFFANY SCHREIBER
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Credential |
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Telephone | 814-866-2277
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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 | DC008772
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License Number State | PA
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