Provider Demographics
NPI:1245422815
Name:SEWICKLEY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:SEWICKLEY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-741-5451
Mailing Address - Street 1:409 BROAD ST
Mailing Address - Street 2:SUITE 101-A
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1557
Mailing Address - Country:US
Mailing Address - Phone:412-741-5451
Mailing Address - Fax:412-741-5452
Practice Address - Street 1:409 BROAD ST
Practice Address - Street 2:SUITE 101-A
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1557
Practice Address - Country:US
Practice Address - Phone:412-741-5451
Practice Address - Fax:412-741-5452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty