Provider Demographics
NPI:1083781181
Name:CLICK, JOSHUA WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WAYNE
Last Name:CLICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-1638
Mailing Address - Country:US
Mailing Address - Phone:724-372-3727
Mailing Address - Fax:
Practice Address - Street 1:220 N BROAD ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1638
Practice Address - Country:US
Practice Address - Phone:724-372-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1720318207OtherGROUP NPI
PA1720318207OtherGROUP NPI
PA182181Medicare UPIN