Provider Demographics
NPI:1093312753
Name:FAMILY CHIROPRACTIC AND SPORTS INJURY CENTER PC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC AND SPORTS INJURY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-319-5653
Mailing Address - Street 1:7313 ROUTE 338 # 107
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:PA
Mailing Address - Zip Code:16232-4927
Mailing Address - Country:US
Mailing Address - Phone:814-992-2001
Mailing Address - Fax:702-446-8107
Practice Address - Street 1:7313 ROUTE 338 # 107
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:PA
Practice Address - Zip Code:16232-4927
Practice Address - Country:US
Practice Address - Phone:814-992-2001
Practice Address - Fax:702-446-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty