Provider Demographics
NPI:1902231434
Name:BUCKAROO CHIROPRACTIC
Entity Type:Organization
Organization Name:BUCKAROO CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-803-2648
Mailing Address - Street 1:300 CAMP HORNE RD # 210
Mailing Address - Street 2:
Mailing Address - City:EMSWORTH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-1627
Mailing Address - Country:US
Mailing Address - Phone:412-535-4841
Mailing Address - Fax:
Practice Address - Street 1:300 CAMP HORNE RD # 210
Practice Address - Street 2:
Practice Address - City:EMSWORTH
Practice Address - State:PA
Practice Address - Zip Code:15202-1627
Practice Address - Country:US
Practice Address - Phone:412-535-4841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADC010553Medicare PIN