Provider Demographics
NPI:1598818379
Name:MICHAEL L POLLARD DC PC
Entity Type:Organization
Organization Name:MICHAEL L POLLARD DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-626-7300
Mailing Address - Street 1:85 N LANSDOWNE AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2073
Mailing Address - Country:US
Mailing Address - Phone:610-626-7300
Mailing Address - Fax:610-626-7302
Practice Address - Street 1:85 N LANSDOWNE AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2073
Practice Address - Country:US
Practice Address - Phone:610-626-7300
Practice Address - Fax:610-626-7302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004189L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U01483Medicare UPIN
PAP0588107Medicare ID - Type Unspecified