MEDICARE: CHIROPRACTIC HEALTH CENTER

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
1	111N00000X	Chiropractor	DC001312L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1598844300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC HEALTH CENTER

Provider Business Mailing Address
First Line	:	3130 MEMORIAL HWY
Second Line	:	SUITE 100
City	:	DALLAS
State	:	PA
Zip	:	18612-9228
Country	:	US
Telephone Number	:	570-675-3833
Fax Number	:	570-675-3225

Provider Business Practice Location Address
First Line	:	3130 MEMORIAL HWY
Second Line	:	SUITE 100
City	:	DALLAS
State	:	PA
Zip	:	18612-9228
Country	:	US
Telephone Number	:	570-675-3833
Fax Number	:	570-675-3225

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. GERALDINE M SPENCER
Credential	:
Telephone Number	:	570-675-3833

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	09/21/2011

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Directions to “CHIROPRACTIC HEALTH CENTER ” Practice Location

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