Provider Demographics
NPI:1518987023
Name:PROFESSIONAL FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIORDANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-754-6577
Mailing Address - Street 1:296 HOFFMANSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BECHTELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19505-9517
Mailing Address - Country:US
Mailing Address - Phone:610-754-6577
Mailing Address - Fax:
Practice Address - Street 1:296 HOFFMANSVILLE RAOD
Practice Address - Street 2:
Practice Address - City:SASSAMANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19472
Practice Address - Country:US
Practice Address - Phone:610-754-6577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004999L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2852135OtherAETNA HMO
PA5040006OtherAETNA NON-HMO
PA0684152000OtherINDEPENDENCE BLUE CROSS
PA5002582OtherCAPITOL BLUE CROSS
PAPR507287OtherHIGHMARK/ BLUE SHIELD
PA063448Medicare PIN