Provider Demographics
NPI:1639222813
Name:FAY WEST CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:FAY WEST CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMONAI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-547-1800
Mailing Address - Street 1:RR 7 BOX 812
Mailing Address - Street 2:CROSSROADS PLAZA
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-8900
Mailing Address - Country:US
Mailing Address - Phone:724-547-1800
Mailing Address - Fax:724-547-1802
Practice Address - Street 1:RR 7 BOX 812
Practice Address - Street 2:CROSSROADS PLAZA
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-8900
Practice Address - Country:US
Practice Address - Phone:724-547-1800
Practice Address - Fax:724-547-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA007450Medicare ID - Type Unspecified