Provider Demographics
NPI:1497934756
Name:LANCASTER CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:LANCASTER CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-898-2400
Mailing Address - Street 1:2827 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2101
Mailing Address - Country:US
Mailing Address - Phone:717-898-2400
Mailing Address - Fax:717-898-7543
Practice Address - Street 1:2827 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2101
Practice Address - Country:US
Practice Address - Phone:717-898-2400
Practice Address - Fax:717-898-7543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002030L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty