Provider Demographics
NPI:1437195930
Name:PRO ADJUSTER REHABILITATION
Entity Type:Organization
Organization Name:PRO ADJUSTER REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SWADE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-466-9100
Mailing Address - Street 1:523 RAVINE ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DRAVOSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15034-1012
Mailing Address - Country:US
Mailing Address - Phone:412-466-9100
Mailing Address - Fax:412-466-9485
Practice Address - Street 1:523 RAVINE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:DRAVOSBURG
Practice Address - State:PA
Practice Address - Zip Code:15034-1012
Practice Address - Country:US
Practice Address - Phone:412-466-9100
Practice Address - Fax:412-466-9485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007537L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty