Provider Demographics
NPI:1245409937
Name:STEEL CITY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:STEEL CITY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MONTESANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-860-0798
Mailing Address - Street 1:11 MEADOWCREST DR
Mailing Address - Street 2:
Mailing Address - City:CECIL
Mailing Address - State:PA
Mailing Address - Zip Code:15321-1119
Mailing Address - Country:US
Mailing Address - Phone:843-860-0798
Mailing Address - Fax:
Practice Address - Street 1:11 MEADOWCREST DR
Practice Address - Street 2:
Practice Address - City:CECIL
Practice Address - State:PA
Practice Address - Zip Code:15321-1119
Practice Address - Country:US
Practice Address - Phone:843-860-0798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1828970OtherHIGHMARK
PAV09849Medicare UPIN