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NPI Code Detail

MEDICARE: INDIANA CHIROPRACTIC, INC.

MEDICARE: INDIANA CHIROPRACTIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC002862LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205894912
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIANA CHIROPRACTIC, INC.
Provider Business Mailing Address
First Line : 272 RUSTIC LODGE ROAD
Second Line :
City : INDIANA
State : PA
Zip : 15701-1595
Country : US
Telephone Number : 724-465-5608
Fax Number : 724-465-2168
Provider Business Practice Location Address
First Line : 272 RUSTIC LODGE ROAD
Second Line :
City : INDIANA
State : PA
Zip : 15701-1595
Country : US
Telephone Number : 724-465-5608
Fax Number : 724-465-2168
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHRISTOPHER J. SHARBAUGH
Credential : DC
Telephone Number : 724-465-5608
Provider Enumeration Date : 05/02/2006
Last Update Date : 02/10/2020

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Directions to “INDIANA CHIROPRACTIC, INC. ” Practice Location

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