Provider Demographics
NPI:1235193285
Name:ELK COUNTY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ELK COUNTY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPOVETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-781-7208
Mailing Address - Street 1:246 CHESTNUT ST
Mailing Address - Street 2:P.O. BOX 27
Mailing Address - City:ST MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-1708
Mailing Address - Country:US
Mailing Address - Phone:814-781-7208
Mailing Address - Fax:814-781-8505
Practice Address - Street 1:246 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1708
Practice Address - Country:US
Practice Address - Phone:814-781-7208
Practice Address - Fax:814-781-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002175-L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALE404693Medicare ID - Type Unspecified
PA404693Medicare UPIN