Provider Demographics
NPI:1093877524
Name:HERD CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:HERD CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-737-1681
Mailing Address - Street 1:2704 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4531
Mailing Address - Country:US
Mailing Address - Phone:717-737-1681
Mailing Address - Fax:717-731-1648
Practice Address - Street 1:2704 MARKET STREET
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4531
Practice Address - Country:US
Practice Address - Phone:717-737-1681
Practice Address - Fax:717-731-1648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA001119L111N00000X
PA004479L111N00000X
PA002730L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
212110925OtherCIGNA CLINIC
002730LOtherLICENSE NUMBER DINCHER
350020641OtherRAILROAD MEDICARE CARVER
JH1018019OtherASH LINK
121006KPKOtherDINCHER BLUE SHIELD
658217KPKOtherBLUE SHIELD CARVER
001119LOtherLICENSE NUMBER HERD
004479LOtherLICENSE NUMBER CARVER
350020639OtherRAILROAD MEDICARE DINCHER
115888KPKOtherBLUE SHIELD HERD
350020638OtherRAILROAD MEDICARE HERD
350020638OtherRAILROAD MEDICARE HERD
T29080Medicare UPIN
010101Medicare ID - Type UnspecifiedCHRONIC
658217KPKMedicare ID - Type UnspecifiedCARVER
001119LOtherLICENSE NUMBER HERD
212110925OtherCIGNA CLINIC
T29254Medicare UPIN
658217KPKOtherBLUE SHIELD CARVER
010100Medicare Oscar/Certification