Provider Demographics
NPI: | 1376765909 |
---|---|
Name: | HAMPTON CHIROPRACTIC |
Entity Type: | Organization |
Organization Name: | HAMPTON CHIROPRACTIC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PROPRIETOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | RENEE |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | STAUFFACHER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 412-487-4696 |
Mailing Address - Street 1: | 4284 ROUTE 8 |
Mailing Address - Street 2: | SUITE 202 |
Mailing Address - City: | ALLISON PARK |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15101 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-487-4696 |
Mailing Address - Fax: | 412-487-4697 |
Practice Address - Street 1: | 4284 ROUTE 8 |
Practice Address - Street 2: | SUITE 202 |
Practice Address - City: | ALLISON PARK |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15101 |
Practice Address - Country: | US |
Practice Address - Phone: | 412-487-4696 |
Practice Address - Fax: | 412-487-4697 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-05-03 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | DC009774 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |