Provider Demographics
NPI:1073728887
Name:SPINAL HEALTHCARE CENTER, P.C.
Entity Type:Organization
Organization Name:SPINAL HEALTHCARE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:412-373-2886
Mailing Address - Street 1:4055 MONROEVILLE BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2522
Mailing Address - Country:US
Mailing Address - Phone:412-373-2886
Mailing Address - Fax:412-373-2887
Practice Address - Street 1:4055 MONROEVILLE BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2522
Practice Address - Country:US
Practice Address - Phone:412-373-2886
Practice Address - Fax:412-373-2887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004881L111N00000X
PADC006664L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty