Provider Demographics
NPI:1346855442
Name:PUSKAR CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:PUSKAR CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PUSKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-977-4527
Mailing Address - Street 1:40 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-1269
Mailing Address - Country:US
Mailing Address - Phone:724-962-5025
Mailing Address - Fax:
Practice Address - Street 1:40 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:SHARPSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16150-1269
Practice Address - Country:US
Practice Address - Phone:724-962-5025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty