Provider Demographics
NPI:1902008105
Name:ALPHA CHIROPRACTIC
Entity Type:Organization
Organization Name:ALPHA CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:GIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-334-5417
Mailing Address - Street 1:2027 LORRAINE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19604-1420
Mailing Address - Country:US
Mailing Address - Phone:610-334-5417
Mailing Address - Fax:610-376-7599
Practice Address - Street 1:225 N 6TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3384
Practice Address - Country:US
Practice Address - Phone:610-376-0251
Practice Address - Fax:610-376-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005000L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty