Provider Demographics
NPI:1477120806
Name:CENTERED CHIROPRACTIC PA
Entity Type:Organization
Organization Name:CENTERED CHIROPRACTIC PA
Other - Org Name:ELITE CHIROPRACTIC CENTER OF CLAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BONHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-251-8573
Mailing Address - Street 1:8928 US 70 BUS HWY W STE 700
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-4847
Mailing Address - Country:US
Mailing Address - Phone:919-553-5505
Mailing Address - Fax:919-553-9909
Practice Address - Street 1:8928 US 70 BUS HWY W STE 700
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4847
Practice Address - Country:US
Practice Address - Phone:919-553-5505
Practice Address - Fax:919-553-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty