Provider Demographics
NPI:1689732281
Name:CHESTNUT HILL FAMILY CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:CHESTNUT HILL FAMILY CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:MITTICA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-825-5282
Mailing Address - Street 1:2 SCARLET OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444
Mailing Address - Country:US
Mailing Address - Phone:610-825-5282
Mailing Address - Fax:610-825-8206
Practice Address - Street 1:2 SCARLET OAK DRIVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444
Practice Address - Country:US
Practice Address - Phone:610-825-5282
Practice Address - Fax:610-825-8206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty