Provider Demographics
NPI:1821322132
Name:GRAHAM FAMILY CHIROPRATIC PC
Entity Type:Organization
Organization Name:GRAHAM FAMILY CHIROPRATIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ERBE GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-632-0059
Mailing Address - Street 1:1785 BALTIMORE PIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-6705
Mailing Address - Country:US
Mailing Address - Phone:717-632-0059
Mailing Address - Fax:
Practice Address - Street 1:1785 BALTIMORE PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-6705
Practice Address - Country:US
Practice Address - Phone:717-632-0059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA400372OtherHIGHMARK BLUE SHIELD OF PA
PA056688Medicare PIN