=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811184377
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAMER CHIROPRACTIC CENTER, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2007
-----------------------------------------------------
Last Update Date | 04/04/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3010 MAPLE AVE
-----------------------------------------------------
City | ALTOONA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16601-1736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-940-8888
-----------------------------------------------------
Fax | 814-940-8988
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3010 MAPLE AVE
-----------------------------------------------------
City | ALTOONA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16601-1736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-940-8888
-----------------------------------------------------
Fax | 814-940-8988
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOHN ERIC HAMER
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 814-201-2653
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC006598L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------