Provider Demographics
NPI:1225213010
Name:PACI CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:PACI CHIROPRACTIC, INC.
Other - Org Name:ATTILIO A. PACI, D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ATTILIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PACI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-733-4445
Mailing Address - Street 1:200 NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2920
Mailing Address - Country:US
Mailing Address - Phone:301-733-4445
Mailing Address - Fax:301-733-3383
Practice Address - Street 1:200 NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2920
Practice Address - Country:US
Practice Address - Phone:301-733-4445
Practice Address - Fax:301-733-3383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD227NMedicare UPIN
MD227N245GMedicare UPIN