Provider Demographics
NPI:1659458545
Name:NARDONE CHIROPRACTIC,NORTH,PLLC
Entity Type:Organization
Organization Name:NARDONE CHIROPRACTIC,NORTH,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:NARDONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-723-2494
Mailing Address - Street 1:126 MELINDA DR
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-4049
Mailing Address - Country:US
Mailing Address - Phone:304-639-9166
Mailing Address - Fax:
Practice Address - Street 1:117 B THREE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3827
Practice Address - Country:US
Practice Address - Phone:304-723-2494
Practice Address - Fax:304-723-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2203034000Medicaid
1164417754OtherNPI
WVU89329Medicare UPIN
9342411Medicare ID - Type Unspecified
6346450001Medicare NSC