Provider Demographics
NPI:1417913286
Name:LAUBACH FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LAUBACH FAMILY CHIROPRACTIC LLC
Other - Org Name:BACK 2 HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LAUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-629-9507
Mailing Address - Street 1:2369 ROUTE 715
Mailing Address - Street 2:
Mailing Address - City:TANNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18372
Mailing Address - Country:US
Mailing Address - Phone:570-629-9507
Mailing Address - Fax:272-200-2977
Practice Address - Street 1:2369 ROUTE 715
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18372
Practice Address - Country:US
Practice Address - Phone:570-629-9507
Practice Address - Fax:272-200-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7640701000OtherIND. BLUE CROSS
PA1802450OtherBLUE CROSS BLUE SHIELD
PALA099597Medicare UPIN