Provider Demographics
NPI:1760515001
Name:MADDIGAN CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MADDIGAN CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:MADDIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-934-0530
Mailing Address - Street 1:11104 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9367
Mailing Address - Country:US
Mailing Address - Phone:724-934-0530
Mailing Address - Fax:
Practice Address - Street 1:11104 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9367
Practice Address - Country:US
Practice Address - Phone:724-934-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3956-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherEIN
PA=========OtherEIN
PA444198Medicare PIN