Provider Demographics
NPI:1235122110
Name:LABAS, PHILIP G (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:G
Last Name:LABAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20455 ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-7516
Mailing Address - Country:US
Mailing Address - Phone:724-779-1955
Mailing Address - Fax:
Practice Address - Street 1:20455 ROUTE 19
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-7516
Practice Address - Country:US
Practice Address - Phone:724-779-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005888L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1437163OtherBCBS GROUP
PA191883OtherBLUE SHIELD INDIVIDUAL
PA191883Medicare ID - Type UnspecifiedMEDICARE
PA191883OtherBLUE SHIELD INDIVIDUAL