Provider Demographics
NPI:1942427752
Name:ACCIDENT & INJURY CHIROPRACTIC REHAB CENTER, INC.
Entity Type:Organization
Organization Name:ACCIDENT & INJURY CHIROPRACTIC REHAB CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LASKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-299-9758
Mailing Address - Street 1:1873 LINCOLN HWY E
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3398
Mailing Address - Country:US
Mailing Address - Phone:717-299-9758
Mailing Address - Fax:717-299-5574
Practice Address - Street 1:1873 LINCOLN HWY E
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3398
Practice Address - Country:US
Practice Address - Phone:717-299-9758
Practice Address - Fax:717-299-5574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005889-L261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine