Provider Demographics
NPI:1568996841
Name:DZS CHIROPRACTIC
Entity Type:Organization
Organization Name:DZS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-224-2224
Mailing Address - Street 1:825 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014
Mailing Address - Country:US
Mailing Address - Phone:724-224-2224
Mailing Address - Fax:724-224-3988
Practice Address - Street 1:825 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014-1085
Practice Address - Country:US
Practice Address - Phone:724-224-2224
Practice Address - Fax:724-224-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA8723553OtherCIGNA
PA1032406300001Medicaid
PA418322OtherUPMC
PA596115OtherMEDICARE
PA00269448OtherHIGHMARK
PA243255RMFMedicare Oscar/Certification