Provider Demographics
NPI:1790793172
Name:PAMMER CHIROPRACTIC PC
Entity Type:Organization
Organization Name:PAMMER CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAMMER
Authorized Official - Suffix:III
Authorized Official - Credentials:DC,
Authorized Official - Phone:610-264-3344
Mailing Address - Street 1:1104 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CATASAUQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18032-2210
Mailing Address - Country:US
Mailing Address - Phone:610-264-3344
Mailing Address - Fax:610-264-2081
Practice Address - Street 1:1104 6TH ST
Practice Address - Street 2:
Practice Address - City:CATASAUQUA
Practice Address - State:PA
Practice Address - Zip Code:18032-2210
Practice Address - Country:US
Practice Address - Phone:610-264-3344
Practice Address - Fax:610-264-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA004888L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA119590Medicare PIN