Provider Demographics
NPI:1306181714
Name:JAY RUMBAUGH DC LLC
Entity Type:Organization
Organization Name:JAY RUMBAUGH DC LLC
Other - Org Name:RUMBAUGH BACK IN ACTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-852-1624
Mailing Address - Street 1:35 N PORTER ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1427
Mailing Address - Country:US
Mailing Address - Phone:724-852-1624
Mailing Address - Fax:724-852-1592
Practice Address - Street 1:35 N PORTER ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1427
Practice Address - Country:US
Practice Address - Phone:724-852-1624
Practice Address - Fax:724-852-1592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty