Provider Demographics
NPI:1003162157
Name:BEYOND CHIROPRACTIC PC
Entity Type:Organization
Organization Name:BEYOND CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:267-536-2867
Mailing Address - Street 1:404 W RIDGE PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1299
Mailing Address - Country:US
Mailing Address - Phone:267-536-2867
Mailing Address - Fax:
Practice Address - Street 1:404 W RIDGE PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1299
Practice Address - Country:US
Practice Address - Phone:267-536-2867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-26
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty