Provider Demographics
NPI:1073578860
Name:CHIRO DYNAMICS
Entity Type:Organization
Organization Name:CHIRO DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TARTAMOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-757-1212
Mailing Address - Street 1:715 OAKWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356
Mailing Address - Country:US
Mailing Address - Phone:717-848-5550
Mailing Address - Fax:717-848-5551
Practice Address - Street 1:20 NORTH HARRISON STREET
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-848-5550
Practice Address - Fax:717-848-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC6507L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA082149Medicare ID - Type Unspecified
U61476Medicare UPIN