Provider Demographics
NPI:1043497803
Name:MIDDLESEX CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:MIDDLESEX CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:CIMPERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-586-9777
Mailing Address - Street 1:890 PITTSBURGH RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-8958
Mailing Address - Country:US
Mailing Address - Phone:724-586-9777
Mailing Address - Fax:
Practice Address - Street 1:890 PITTSBURGH RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16002-8958
Practice Address - Country:US
Practice Address - Phone:724-586-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003463L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1501103OtherHIGHMARK