Provider Demographics
NPI:1407380652
Name:DZS MEDICAL
Entity Type:Organization
Organization Name:DZS MEDICAL
Other - Org Name:ALLEGHENY HEALTH & PHYSICAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:SPALE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-224-2224
Mailing Address - Street 1:825 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1085
Mailing Address - Country:US
Mailing Address - Phone:724-224-2224
Mailing Address - Fax:724-224-3988
Practice Address - Street 1:825 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014-1085
Practice Address - Country:US
Practice Address - Phone:724-224-2224
Practice Address - Fax:724-224-3988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGHENY HEALTH & CHIROPRACTIC REHAB
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032406300001Medicaid
PA243255RMFMedicare Oscar/Certification