Provider Demographics
NPI:1326269978
Name:CLICK FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:CLICK FAMILY CHIROPRACTIC, LLC
Other - Org Name:CLICK FAMILY CHIROPRACTIC LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-372-3727
Mailing Address - Street 1:220 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-1638
Mailing Address - Country:US
Mailing Address - Phone:724-264-4667
Mailing Address - Fax:724-264-4668
Practice Address - Street 1:220 N BROAD ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1638
Practice Address - Country:US
Practice Address - Phone:724-264-4667
Practice Address - Fax:724-264-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024400550001Medicaid
PA1720318207OtherGROUP NPI
PA1720318207OtherGROUP NPI