Provider Demographics
NPI:1578546685
Name:HAMPTONS CHIROPRACTIC INC
Entity Type:Organization
Organization Name:HAMPTONS CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:570-546-5331
Mailing Address - Street 1:2848 ROUTE 405 HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756
Mailing Address - Country:US
Mailing Address - Phone:570-546-5331
Mailing Address - Fax:570-546-7607
Practice Address - Street 1:2848 ROUTE 405 HIGHWAY
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756
Practice Address - Country:US
Practice Address - Phone:570-546-5331
Practice Address - Fax:570-546-7607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003247L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012582110002Medicaid
PA077646OtherFIRIST PRIOTY HEALTH
PA623318OtherBSBC GROUP
PA616566OtherCOVENTRY HEALTH CARE
PA616566OtherHEALTH ASSURANCE
PA0012582110002Medicaid