Provider Demographics
NPI:1316361090
Name:HEALING ENERGIES CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:HEALING ENERGIES CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:484-791-3553
Mailing Address - Street 1:519 MAIN ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468
Mailing Address - Country:US
Mailing Address - Phone:484-791-3553
Mailing Address - Fax:484-791-3569
Practice Address - Street 1:519 MAIN ST
Practice Address - Street 2:UNIT B
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2305
Practice Address - Country:US
Practice Address - Phone:484-791-3553
Practice Address - Fax:484-791-3569
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING ENERGIES CHIROPRACTIC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0496851000OtherINDEPENDENT BLUE CROSS