Provider Demographics
NPI:1407814684
Name:CARING CHIROPRACTIC SERVICES, PC
Entity Type:Organization
Organization Name:CARING CHIROPRACTIC SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-474-3446
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:7870 WEST RIDGE RD STE 3
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-0914
Mailing Address - Country:US
Mailing Address - Phone:814-474-3446
Mailing Address - Fax:814-474-2535
Practice Address - Street 1:7870 W RIDGE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-1808
Practice Address - Country:US
Practice Address - Phone:814-474-3446
Practice Address - Fax:814-474-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007701L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA083854S8FMedicare PIN