Provider Demographics
NPI:1235336223
Name:CHIROPRACTIC ARTS & REHAB THERAPEUTICS
Entity Type:Organization
Organization Name:CHIROPRACTIC ARTS & REHAB THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRIAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-873-2100
Mailing Address - Street 1:297 W UWCHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3361
Mailing Address - Country:US
Mailing Address - Phone:610-873-2100
Mailing Address - Fax:610-873-2505
Practice Address - Street 1:297 W UWCHLAN AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3361
Practice Address - Country:US
Practice Address - Phone:610-873-2100
Practice Address - Fax:610-873-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC2575L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0026847000OtherINDEPENDENCE BLUE CROSS
PA0129330000OtherKEYSTONE GRP
T28357Medicare UPIN
PA0026847000OtherINDEPENDENCE BLUE CROSS