Provider Demographics
NPI:1629841853
Name:84 CHIROPRACTIC CLINIC, PLLC
Entity Type:Organization
Organization Name:84 CHIROPRACTIC CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:PIASECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-288-4665
Mailing Address - Street 1:369 ROUTE 519 STE B
Mailing Address - Street 2:
Mailing Address - City:EIGHTY FOUR
Mailing Address - State:PA
Mailing Address - Zip Code:15330-2003
Mailing Address - Country:US
Mailing Address - Phone:724-470-9600
Mailing Address - Fax:
Practice Address - Street 1:369 ROUTE 519 STE B
Practice Address - Street 2:
Practice Address - City:EIGHTY FOUR
Practice Address - State:PA
Practice Address - Zip Code:15330-2003
Practice Address - Country:US
Practice Address - Phone:724-470-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty