Provider Demographics
NPI:1467638759
Name:ADVANTAGE CHIROPRACTIC CENTERS, LLC
Entity Type:Organization
Organization Name:ADVANTAGE CHIROPRACTIC CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARBUCKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-285-7600
Mailing Address - Street 1:298 E END AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2808
Mailing Address - Country:US
Mailing Address - Phone:724-775-0600
Mailing Address - Fax:724-775-6775
Practice Address - Street 1:298 E END AVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2808
Practice Address - Country:US
Practice Address - Phone:724-775-0600
Practice Address - Fax:724-775-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008062L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty