Provider Demographics
NPI:1528418290
Name:CASTEEL CHIROPRACTIC OF STATE COLLEGE PC
Entity Type:Organization
Organization Name:CASTEEL CHIROPRACTIC OF STATE COLLEGE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASTEEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-235-9400
Mailing Address - Street 1:1411 N ATHERTON ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-3040
Mailing Address - Country:US
Mailing Address - Phone:814-235-9400
Mailing Address - Fax:814-235-9444
Practice Address - Street 1:1411 N ATHERTON ST
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-3040
Practice Address - Country:US
Practice Address - Phone:814-235-9400
Practice Address - Fax:814-235-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 007932L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018679690001Medicaid
PA001437662OtherHIGHMARK
PA047865Medicare PIN
PAU85125Medicare UPIN