MEDICARE: CHARNEY CHIROPRACTIC LLC

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	DC009076	PA
2	111N00000X	Chiropractor	AJ008899	PA
3	111N00000X	Chiropractor	AJ009137	PA
4	111N00000X	Chiropractor	DC009328	PA

General Provider Information

NPI Number	:	1689778011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARNEY CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	3076 EAGLE VALLEY RD.
Second Line	:
City	:	MILL HALL
State	:	PA
Zip	:	17751-1626
Country	:	US
Telephone Number	:	570-726-2000
Fax Number	:	570-726-8012

Provider Business Practice Location Address
First Line	:	3076 EAGLE VALLEY RD.
Second Line	:
City	:	MILL HALL
State	:	PA
Zip	:	17751-1626
Country	:	US
Telephone Number	:	570-726-2000
Fax Number	:	570-726-8012

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. LEAH M CHARNEY
Credential	:	D.C.
Telephone Number	:	570-726-2000

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	10/23/2014

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