Provider Demographics
NPI:1598813214
Name:PITTSBURGH CHIROPRACTIC & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:PITTSBURGH CHIROPRACTIC & REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOPACINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-787-7400
Mailing Address - Street 1:470 HOME DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1204
Mailing Address - Country:US
Mailing Address - Phone:412-787-7400
Mailing Address - Fax:412-787-7407
Practice Address - Street 1:470 HOME DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1204
Practice Address - Country:US
Practice Address - Phone:412-787-7400
Practice Address - Fax:412-787-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007898L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA453931OtherBS NUMBER
PW1886852OtherCHELE BC BS #
PA1931716OtherCHELE BILLING #
PA1927137OtherJOEL BILLING #
PW1886852OtherCHELE BC BS #