Provider Demographics
NPI:1609035005
Name:LABUDA CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:LABUDA CHIROPRACTIC, LLC
Other - Org Name:DR. SEAN LABUDA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:LABUDA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-222-2660
Mailing Address - Street 1:975 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3867
Mailing Address - Country:US
Mailing Address - Phone:724-222-2660
Mailing Address - Fax:724-223-0933
Practice Address - Street 1:975 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3867
Practice Address - Country:US
Practice Address - Phone:724-222-2660
Practice Address - Fax:724-223-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA146269OtherUNISON
PA1032669OtherASHN
PA001961028Medicaid
PA303595OtherUPMC
PA001515399OtherHIGHMARK
PAU82195Medicare UPIN
PA303595OtherUPMC