Provider Demographics
NPI:1033265152
Name:UNIONTOWN CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:UNIONTOWN CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRET
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:BREAKIRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-437-1910
Mailing Address - Street 1:665 CHERRY TREE LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8947
Mailing Address - Country:US
Mailing Address - Phone:724-437-1910
Mailing Address - Fax:724-437-3227
Practice Address - Street 1:665 CHERRY TREE LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8947
Practice Address - Country:US
Practice Address - Phone:724-437-1910
Practice Address - Fax:724-437-3227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011850530001Medicaid
PA531331JB6Medicare ID - Type Unspecified