Provider Demographics
NPI:1629198528
Name:LATROBE CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:LATROBE CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SARRAF
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:724-537-5266
Mailing Address - Street 1:1901 LIGONIER ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3178
Mailing Address - Country:US
Mailing Address - Phone:724-537-5266
Mailing Address - Fax:724-537-6703
Practice Address - Street 1:1901 LIGONIER ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-3178
Practice Address - Country:US
Practice Address - Phone:724-537-5266
Practice Address - Fax:724-537-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002535L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000482Medicare PIN
PAT26994Medicare UPIN