Provider Demographics
NPI:1013212844
Name:ALWAYS BELIEVE IN YOUR DREAMS, LLC
Entity Type:Organization
Organization Name:ALWAYS BELIEVE IN YOUR DREAMS, LLC
Other - Org Name:KETCHAM CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:KETCHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-337-0128
Mailing Address - Street 1:765 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2546
Mailing Address - Country:US
Mailing Address - Phone:814-337-0128
Mailing Address - Fax:814-337-0164
Practice Address - Street 1:765 PARK AVE
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2546
Practice Address - Country:US
Practice Address - Phone:814-337-0128
Practice Address - Fax:814-337-0164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006808L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA205078OtherUPMC
PAKE596806OtherHIGHMARK BLUE CROSS / BLUE SHIELD
PA001616400 0006Medicaid
PAKE596806OtherHIGHMARK BLUE CROSS / BLUE SHIELD
PA001616400 0006Medicaid