Provider Demographics
NPI:1851528822
Name:CHA CHIROPRACTIC CLINIC P.C.
Entity Type:Organization
Organization Name:CHA CHIROPRACTIC CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YEUNG JU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-820-2581
Mailing Address - Street 1:1218 WELSH RD STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2055
Mailing Address - Country:US
Mailing Address - Phone:215-820-2581
Mailing Address - Fax:267-419-8528
Practice Address - Street 1:1218 WELSH RD STE C
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2055
Practice Address - Country:US
Practice Address - Phone:215-820-2581
Practice Address - Fax:267-419-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3420049000OtherKEYSTONE