Provider Demographics
NPI:1669643128
Name:ALLEGHENY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:ALLEGHENY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:412-460-1166
Mailing Address - Street 1:3000 LEBANON CHURCH ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122
Mailing Address - Country:US
Mailing Address - Phone:412-460-1166
Mailing Address - Fax:412-460-1167
Practice Address - Street 1:3000 LEBANON CHURCH ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122
Practice Address - Country:US
Practice Address - Phone:412-460-1166
Practice Address - Fax:412-460-1167
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGHENY CHIROPRACTIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGR14257375Medicare UPIN
PA064313Medicare Oscar/Certification
PA01921363Medicare PIN