Provider Demographics
NPI:1629166079
Name:PROFESSIONAL CHIROPRACTIC ASSOCIATES, P.C.
Entity type:Organization
Organization Name:PROFESSIONAL CHIROPRACTIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-348-1158
Mailing Address - Street 1:909 ALBRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2500
Mailing Address - Country:US
Mailing Address - Phone:570-348-1158
Mailing Address - Fax:
Practice Address - Street 1:909 ALBRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2500
Practice Address - Country:US
Practice Address - Phone:570-348-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002057L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty