Provider Demographics
NPI:1851413470
Name:IRWIN FAMILY CHIROPRACTIC CLINIC INC.
Entity Type:Organization
Organization Name:IRWIN FAMILY CHIROPRACTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-863-3226
Mailing Address - Street 1:600 OAK ST
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3528
Mailing Address - Country:US
Mailing Address - Phone:724-863-3226
Mailing Address - Fax:724-864-9871
Practice Address - Street 1:600 OAK ST
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3528
Practice Address - Country:US
Practice Address - Phone:724-863-3226
Practice Address - Fax:724-864-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 004460 L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000615305OtherHIGHMARK BC BS GROUP NUMB
PA13221OtherUPMC GROUP NUMBER