Provider Demographics
NPI:1609560309
Name:NASH CHIROPRACTIC HEALTHCARE
Entity Type:Organization
Organization Name:NASH CHIROPRACTIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:P
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-456-1600
Mailing Address - Street 1:3201 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2735
Mailing Address - Country:US
Mailing Address - Phone:814-456-1600
Mailing Address - Fax:814-455-8295
Practice Address - Street 1:3201 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2735
Practice Address - Country:US
Practice Address - Phone:814-456-1600
Practice Address - Fax:814-455-8295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017938350001Medicaid