Provider Demographics
NPI:1457305849
Name:NORTHAMPTON CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:NORTHAMPTON CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLEARIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-365-8488
Mailing Address - Street 1:217 E MOORESTOWN RD STE A
Mailing Address - Street 2:
Mailing Address - City:WIND GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18091-9723
Mailing Address - Country:US
Mailing Address - Phone:610-365-8488
Mailing Address - Fax:610-365-8485
Practice Address - Street 1:217 E MOORESTOWN RD STE A
Practice Address - Street 2:
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-9723
Practice Address - Country:US
Practice Address - Phone:610-365-8488
Practice Address - Fax:610-365-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007169L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1306003OtherHIGHMARK BS
02757800OtherCAPITAL BC
U69288Medicare UPIN
02757800OtherCAPITAL BC