Provider Demographics
NPI:1467584151
Name:JOHN CHRISTOPHER STORTI
Entity Type:Organization
Organization Name:JOHN CHRISTOPHER STORTI
Other - Org Name:CORE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:STORTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-718-1672
Mailing Address - Street 1:180 UNITED PENN PLAZA
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704
Mailing Address - Country:US
Mailing Address - Phone:570-718-1672
Mailing Address - Fax:570-718-1805
Practice Address - Street 1:180 UNITED PENN PLAZA
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704
Practice Address - Country:US
Practice Address - Phone:570-718-1672
Practice Address - Fax:570-718-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007967L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072932Medicare ID - Type Unspecified
U96680Medicare UPIN