Provider Demographics
NPI:1205844545
Name:HALTEMAN FAMILY CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:HALTEMAN FAMILY CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:T
Authorized Official - Last Name:HALTEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-326-1967
Mailing Address - Street 1:745 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7519
Mailing Address - Country:US
Mailing Address - Phone:610-326-1967
Mailing Address - Fax:
Practice Address - Street 1:745 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7519
Practice Address - Country:US
Practice Address - Phone:610-326-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007926L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83081Medicare UPIN
PA081361Medicare ID - Type Unspecified