Provider Demographics
NPI:1194829622
Name:ELLIOTT CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:ELLIOTT CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:P
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-745-1533
Mailing Address - Street 1:113 CAVASINA DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1768
Mailing Address - Country:US
Mailing Address - Phone:724-745-1533
Mailing Address - Fax:724-745-3380
Practice Address - Street 1:113 CAVASINA DR
Practice Address - Street 2:SUITE 600
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1768
Practice Address - Country:US
Practice Address - Phone:724-745-1533
Practice Address - Fax:724-745-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty