Provider Demographics
NPI:1033379904
Name:WELDON CHIROPRACTIC INC
Entity Type:Organization
Organization Name:WELDON CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-537-2445
Mailing Address - Street 1:330 WELDON ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1851
Mailing Address - Country:US
Mailing Address - Phone:724-537-2445
Mailing Address - Fax:724-539-2909
Practice Address - Street 1:330 WELDON ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1851
Practice Address - Country:US
Practice Address - Phone:724-537-2445
Practice Address - Fax:724-539-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC000829L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA107192OtherHIGHMARK BC/BS