MEDICARE: ELLEN S JACKSON STROBEL DC

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	DC007701L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0013447766	OTHER	PA	HIGHMARK BLUE CROSS BLUE

General Provider Information

NPI Number	:	1740280700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN S JACKSON STROBEL DC

Provider Business Mailing Address
First Line	:	PO BOX 914
Second Line	:	7870 WEST RIDGE RD, STE 3
City	:	FAIRVIEW
State	:	PA
Zip	:	16415-0914
Country	:	US
Telephone Number	:	814-474-3446
Fax Number	:	814-474-2535

Provider Business Practice Location Address
First Line	:	7870 W RIDGE RD
Second Line	:	SUITE 3
City	:	FAIRVIEW
State	:	PA
Zip	:	16415-1808
Country	:	US
Telephone Number	:	814-474-3446
Fax Number	:	814-474-2535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/01/2024

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Directions to “ ELLEN S JACKSON STROBEL DC” Practice Location

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