Provider Demographics
NPI:1346780004
Name:LAUREL VALLEY CHIROPRACTIC
Entity Type:Organization
Organization Name:LAUREL VALLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-639-3117
Mailing Address - Street 1:601 SALT ST
Mailing Address - Street 2:
Mailing Address - City:SALTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15681-1127
Mailing Address - Country:US
Mailing Address - Phone:724-639-3117
Mailing Address - Fax:724-639-3117
Practice Address - Street 1:601 SALT ST
Practice Address - Street 2:
Practice Address - City:SALTSBURG
Practice Address - State:PA
Practice Address - Zip Code:15681-1127
Practice Address - Country:US
Practice Address - Phone:724-639-3117
Practice Address - Fax:724-639-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty