Provider Demographics
NPI:1639364417
Name:JANGDHARI FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:JANGDHARI FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:JANGDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-299-1267
Mailing Address - Street 1:117 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-5417
Mailing Address - Country:US
Mailing Address - Phone:717-299-1267
Mailing Address - Fax:
Practice Address - Street 1:117 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-5417
Practice Address - Country:US
Practice Address - Phone:717-299-1267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002272L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA129899OtherMEDICARE PROVIDER TRANSACTION ACCESS NUMBER