Provider Demographics
NPI:1568427326
Name:CHAMBERSBURG CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:CHAMBERSBURG CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-263-4835
Mailing Address - Street 1:1461 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-3341
Mailing Address - Country:US
Mailing Address - Phone:717-263-4835
Mailing Address - Fax:717-263-5117
Practice Address - Street 1:1461 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-3341
Practice Address - Country:US
Practice Address - Phone:717-263-4835
Practice Address - Fax:717-263-5117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111540Medicare PIN