Provider Demographics
NPI:1821148362
Name:MIDDLETON CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:MIDDLETON CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-827-9970
Mailing Address - Street 1:128 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-1726
Mailing Address - Country:US
Mailing Address - Phone:814-827-9970
Mailing Address - Fax:814-827-9971
Practice Address - Street 1:128 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1726
Practice Address - Country:US
Practice Address - Phone:814-827-9970
Practice Address - Fax:814-827-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007629L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00165689OtherRAIL ROAD MEDICARE
PA000861662OtherBC BS MEDICARE
PA037618Q7VOtherMEDICARE ORIGINAL GROUP NUMBER BEFORE NPI
PA1036231OtherAMERICAN SPECIALTY HEALTH
PA0018122420003Medicaid
PAV0F118OtherUPMC
PA411278OtherHEALTH ASSURANCE &AMERICA
PA001346928OtherBC BS #
PA0018122420002Medicaid
PA037618Q7VOtherMEDICARE ORIGINAL GROUP NUMBER BEFORE NPI