Provider Demographics
NPI:1093822439
Name:HONESDALE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:HONESDALE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAMES-COBOURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-253-9039
Mailing Address - Street 1:200 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1150
Mailing Address - Country:US
Mailing Address - Phone:570-253-9039
Mailing Address - Fax:570-253-9052
Practice Address - Street 1:200 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1150
Practice Address - Country:US
Practice Address - Phone:570-253-9039
Practice Address - Fax:570-253-9052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty