Provider Demographics
NPI:1285857128
Name:SAVONA FAMILY CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:SAVONA FAMILY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAVONA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-249-9200
Mailing Address - Street 1:179 N MAIN ST STE 201
Mailing Address - Street 2:PO BOX 265
Mailing Address - City:DUBLIN
Mailing Address - State:PA
Mailing Address - Zip Code:18917-2107
Mailing Address - Country:US
Mailing Address - Phone:215-249-9200
Mailing Address - Fax:215-249-3118
Practice Address - Street 1:179 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:PA
Practice Address - Zip Code:18917-2107
Practice Address - Country:US
Practice Address - Phone:215-249-9200
Practice Address - Fax:215-249-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2341923000OtherIBC
PA2341923000OtherKEYSTONE
PA1660754OtherHIGHMARK BLUESHIELD
PA1003846437OtherNPI PROVIDER NUMBER
PA2341923000OtherAMERIHEALTH
PA3795620OtherAETNA
PA2341923000OtherAMERIHEALTH