Provider Demographics
NPI:1578330460
Name:EXCELSIOR CHIROPRACTIC
Entity Type:Organization
Organization Name:EXCELSIOR CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMENDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-412-7131
Mailing Address - Street 1:4456 OAKHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3452
Mailing Address - Country:US
Mailing Address - Phone:717-412-7131
Mailing Address - Fax:
Practice Address - Street 1:4456 OAKHURST BLVD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3452
Practice Address - Country:US
Practice Address - Phone:717-412-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty