Provider Demographics
NPI:1073707873
Name:YANULAVICH CHIROPRACTIC
Entity Type:Organization
Organization Name:YANULAVICH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:YANULAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-344-6073
Mailing Address - Street 1:727 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-1542
Mailing Address - Country:US
Mailing Address - Phone:570-344-6073
Mailing Address - Fax:
Practice Address - Street 1:727 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-1542
Practice Address - Country:US
Practice Address - Phone:570-344-6073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002053L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty