Provider Demographics
NPI:1215182274
Name:SHRIVER CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:SHRIVER CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-255-9540
Mailing Address - Street 1:465 DONNAN AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:382 W CHESTNUT ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4642
Practice Address - Country:US
Practice Address - Phone:724-225-1655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009848111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty