Provider Demographics
NPI:1154510071
Name:COCO CHIROPRACTIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:COCO CHIROPRACTIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:COCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-523-2712
Mailing Address - Street 1:4540 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-2002
Mailing Address - Country:US
Mailing Address - Phone:724-327-1333
Mailing Address - Fax:724-327-1334
Practice Address - Street 1:4540 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-2002
Practice Address - Country:US
Practice Address - Phone:724-327-1333
Practice Address - Fax:724-327-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009326111N00000X
PAAJ009135111N00000X
PADC009327111N00000X
PAAJ009136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty