Provider Demographics
NPI:1053334474
Name:NICASTRO CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:NICASTRO CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MANTZ
Authorized Official - Last Name:NICASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PT
Authorized Official - Phone:717-243-6396
Mailing Address - Street 1:1224 HOLLY PIKE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4240
Mailing Address - Country:US
Mailing Address - Phone:717-243-6396
Mailing Address - Fax:717-243-6444
Practice Address - Street 1:1224 HOLLY PIKE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4240
Practice Address - Country:US
Practice Address - Phone:717-243-6396
Practice Address - Fax:717-243-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-7102-L111N00000X
NYPT7104E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty