Provider Demographics
NPI:1598879207
Name:DISCOVER CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:DISCOVER CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QWNER/OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUTERMILCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-536-4002
Mailing Address - Street 1:1307 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1234
Mailing Address - Country:US
Mailing Address - Phone:215-536-4002
Mailing Address - Fax:215-536-4002
Practice Address - Street 1:1307 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1234
Practice Address - Country:US
Practice Address - Phone:215-536-4002
Practice Address - Fax:215-536-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000082744OtherHIGHMARK BLUE SHIELD ID
PA0323034000OtherINDEPENDENCE BLUE CROSS
PA2356515OtherAETNA ID
PA066317Medicare ID - Type Unspecified