Provider Demographics
NPI:1124044094
Name:FRAZETTA CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:FRAZETTA CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FRAZETTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-274-9440
Mailing Address - Street 1:846 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144
Mailing Address - Country:US
Mailing Address - Phone:724-274-9440
Mailing Address - Fax:724-274-0858
Practice Address - Street 1:846 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:PA
Practice Address - Zip Code:15144
Practice Address - Country:US
Practice Address - Phone:724-274-9440
Practice Address - Fax:724-274-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005111L111N00000X
PADC005110L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U37611Medicare UPIN