Provider Demographics
NPI:1265832000
Name:COMPLETE CARE FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:COMPLETE CARE FAMILY CHIROPRACTIC, LLC
Other - Org Name:BALANCED HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-382-3034
Mailing Address - Street 1:1506 SCRANTON CARBONDALE HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-1136
Mailing Address - Country:US
Mailing Address - Phone:570-382-3034
Mailing Address - Fax:570-382-3027
Practice Address - Street 1:1506 SCRANTON CARBONDALE HWY
Practice Address - Street 2:SUITE A
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-1136
Practice Address - Country:US
Practice Address - Phone:570-382-3034
Practice Address - Fax:570-382-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty