Provider Demographics
NPI:1699808022
Name:AMES CHIROPRACTIC PC
Entity Type:Organization
Organization Name:AMES CHIROPRACTIC PC
Other - Org Name:MICHAEL R AMES DC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-536-4610
Mailing Address - Street 1:609 S WEST END BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1424
Mailing Address - Country:US
Mailing Address - Phone:215-536-4610
Mailing Address - Fax:215-536-5289
Practice Address - Street 1:609 S WEST END BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1424
Practice Address - Country:US
Practice Address - Phone:215-536-4610
Practice Address - Fax:215-536-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003913L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0386044000OtherKEYSTONE HEALTH PLAN
PA50004518OtherCAPITAL
PA0386044000OtherINDEPENDENCE BLUE CROSS
PA2048415OtherAETNA
PA564698OtherHIGHMARK
PAP842989OtherOXFORD
PA0386044000OtherINDEPENDENCE BLUE CROSS