Provider Demographics
NPI:1326106261
Name:CORCORAN, CLAIRE K (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:K
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S. STATE RD.
Mailing Address - Street 2:SUITE 100G
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064
Mailing Address - Country:US
Mailing Address - Phone:484-472-6435
Mailing Address - Fax:610-325-6039
Practice Address - Street 1:130 S. STATE RD.
Practice Address - Street 2:SUITE 100G
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064
Practice Address - Country:US
Practice Address - Phone:484-472-6435
Practice Address - Fax:610-325-6039
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAV08839Medicare UPIN
PA099876PCHMedicare PIN