1316077803 NPI number — STRASISER CHIROPRACTIC, INC

Table of content: (NPI 1316077803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316077803 NPI number — STRASISER CHIROPRACTIC, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STRASISER CHIROPRACTIC, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316077803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3371 SEANOR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLSOPPLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15935-8606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-479-2561
Provider Business Mailing Address Fax Number:
814-479-2935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3371 SEANOR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLSOPPLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15935-8606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-479-2561
Provider Business Practice Location Address Fax Number:
814-479-2935
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
ONDREA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
814-479-2562

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC-004249-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 337749 . This is a "HEALTHASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012245900004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001417077 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1017902 . This is a "AMERICAN SPECIALTY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103005 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1516495 . This is a "THE FUNDS UMWA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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