Provider Demographics
NPI:1326106584
Name:VALLEY HEALTH CHIROPRACTIC INC
Entity Type:Organization
Organization Name:VALLEY HEALTH CHIROPRACTIC INC
Other - Org Name:HEALTHSOURCE OF BETHLEHEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HURON
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:610-691-4444
Mailing Address - Street 1:3864 COURTNEY ST
Mailing Address - Street 2:#150
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8987
Mailing Address - Country:US
Mailing Address - Phone:610-691-4444
Mailing Address - Fax:610-691-4455
Practice Address - Street 1:3864 COURTNEY ST
Practice Address - Street 2:#150
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8987
Practice Address - Country:US
Practice Address - Phone:610-691-4444
Practice Address - Fax:610-691-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005305L111N00000X
PADC-AJ005305L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA837241Medicare ID - Type UnspecifiedMEDICARE
PAU60926Medicare UPIN