Provider Demographics
NPI:1871850685
Name:SCHWARTZ CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SCHWARTZ CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-617-9973
Mailing Address - Street 1:79 MACOMB ST
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:17959-1031
Mailing Address - Country:US
Mailing Address - Phone:570-617-9973
Mailing Address - Fax:
Practice Address - Street 1:216 N 12TH ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2243
Practice Address - Country:US
Practice Address - Phone:570-617-9973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010521261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center