Provider Demographics
NPI:1093924896
Name:CHIROPRACTIC HEALING CENTER
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SINISGALLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-992-7100
Mailing Address - Street 1:3203 HAMILTON E
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-9552
Mailing Address - Country:US
Mailing Address - Phone:570-992-7100
Mailing Address - Fax:570-992-7473
Practice Address - Street 1:3203 HAMILTON E
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-9552
Practice Address - Country:US
Practice Address - Phone:570-992-7100
Practice Address - Fax:570-992-7473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007446L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SI031876Medicare ID - Type Unspecified