Provider Demographics
NPI:1467621367
Name:STRUPE CHIROPRACTIC CENTER, PA
Entity Type:Organization
Organization Name:STRUPE CHIROPRACTIC CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:J
Authorized Official - Last Name:STRUPE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:336-722-2011
Mailing Address - Street 1:128 N SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2734
Mailing Address - Country:US
Mailing Address - Phone:336-722-2011
Mailing Address - Fax:
Practice Address - Street 1:128 N SPRUCE ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2734
Practice Address - Country:US
Practice Address - Phone:336-722-2011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1219261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08838OtherBCBS
NC08838OtherBCBS
NC244091Medicare PIN