Provider Demographics
NPI:1700818572
Name:FOEDISCH CHIROPRACTIC HEALTH CENTER, PC
Entity Type:Organization
Organization Name:FOEDISCH CHIROPRACTIC HEALTH CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:FOEDISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-721-2300
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:665 HARLEYSVILLE PIKE
Mailing Address - City:FRANCONIA
Mailing Address - State:PA
Mailing Address - Zip Code:18924
Mailing Address - Country:US
Mailing Address - Phone:215-721-2300
Mailing Address - Fax:215-721-9655
Practice Address - Street 1:665 HARLEYSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:PA
Practice Address - Zip Code:18924
Practice Address - Country:US
Practice Address - Phone:215-721-2300
Practice Address - Fax:215-721-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002921L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0956919OtherAETNA
PAJ25935OtherAMERIHEALTH
PA0048403000OtherKEYSTONE HEALTH PLAN EAST
PA0048403000OtherINDEPENDENCE BC
PAJ25935OtherAMERIHEALTH
PA025935Medicare ID - Type Unspecified