Provider Demographics
NPI:1457476236
Name:FAMILY CHIROPRACTIC CENTERS, INC.
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PETRISKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-787-3320
Mailing Address - Street 1:6091 STEUBENVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1336
Mailing Address - Country:US
Mailing Address - Phone:412-787-3320
Mailing Address - Fax:412-494-9579
Practice Address - Street 1:6091 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1336
Practice Address - Country:US
Practice Address - Phone:412-787-3320
Practice Address - Fax:412-494-9579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFA486588Medicare PIN