Provider Demographics
NPI:1922140177
Name:SPRINGFIELD FAMILY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:SPRINGFIELD FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-544-6336
Mailing Address - Street 1:7 E WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2310
Mailing Address - Country:US
Mailing Address - Phone:610-544-6336
Mailing Address - Fax:610-544-7059
Practice Address - Street 1:7 E WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2310
Practice Address - Country:US
Practice Address - Phone:610-544-6336
Practice Address - Fax:610-544-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006703L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1932252566OtherINDIVIDUAL PROVIDER NO.