Provider Demographics
NPI:1790711307
Name:EWER SPECIFIC CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:EWER SPECIFIC CHIROPRACTIC, P.C.
Other - Org Name:EWER SPECIFIC CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:EWER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-836-5520
Mailing Address - Street 1:298 OLD ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6992
Mailing Address - Country:US
Mailing Address - Phone:724-836-5520
Mailing Address - Fax:724-836-5565
Practice Address - Street 1:298 OLD ROUTE 30
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6992
Practice Address - Country:US
Practice Address - Phone:724-836-5520
Practice Address - Fax:724-836-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007435L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1326549OtherBC/BS
PA1326549OtherBC/BS
PA045749Medicare ID - Type Unspecified