Provider Demographics
NPI:1891230587
Name:LISA A MCHUGH, D.C., LLC
Entity Type:Organization
Organization Name:LISA A MCHUGH, D.C., LLC
Other - Org Name:JENNERS CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-629-5581
Mailing Address - Street 1:5093 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:JENNERS
Mailing Address - State:PA
Mailing Address - Zip Code:15546-9606
Mailing Address - Country:US
Mailing Address - Phone:814-629-5581
Mailing Address - Fax:
Practice Address - Street 1:5093 FRONT ST
Practice Address - Street 2:
Practice Address - City:JENNERS
Practice Address - State:PA
Practice Address - Zip Code:15546-9606
Practice Address - Country:US
Practice Address - Phone:814-629-5581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005326L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty