Provider Demographics
NPI:1275666232
Name:LEHIGH VALLEY SPINAL CARE CENTER
Entity Type:Organization
Organization Name:LEHIGH VALLEY SPINAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-760-8888
Mailing Address - Street 1:4450 W MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WALNUTPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18088-9429
Mailing Address - Country:US
Mailing Address - Phone:610-767-8888
Mailing Address - Fax:610-760-8965
Practice Address - Street 1:4450 W MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-9429
Practice Address - Country:US
Practice Address - Phone:610-767-8888
Practice Address - Fax:610-760-8965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007463L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1659390128OtherINDIVIDUAL NPI
PA01734709Medicaid
PABU022880Medicare ID - Type Unspecified
PA01734709Medicaid