Provider Demographics
NPI:1083255004
Name:PITTSBURGH MOBILE CHIROPRACTIC
Entity Type:Organization
Organization Name:PITTSBURGH MOBILE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BUNCKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-404-6725
Mailing Address - Street 1:637 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:PA
Mailing Address - Zip Code:15046-5450
Mailing Address - Country:US
Mailing Address - Phone:412-404-6725
Mailing Address - Fax:
Practice Address - Street 1:637 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:CRESCENT
Practice Address - State:PA
Practice Address - Zip Code:15046-5450
Practice Address - Country:US
Practice Address - Phone:412-404-6725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty