Provider Demographics
NPI:1952316556
Name:ADVANCED BACK AND NECK CARE OF LOWER BUCKS COUNTY, P.C.
Entity Type:Organization
Organization Name:ADVANCED BACK AND NECK CARE OF LOWER BUCKS COUNTY, P.C.
Other - Org Name:HALUSHKA CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:HALUSHKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-322-1880
Mailing Address - Street 1:347 SECOND STREET PIKE, SUITE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3831
Mailing Address - Country:US
Mailing Address - Phone:215-322-1880
Mailing Address - Fax:215-396-0381
Practice Address - Street 1:347 SECOND STREET PIKE STE 2
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3831
Practice Address - Country:US
Practice Address - Phone:215-322-1880
Practice Address - Fax:215-396-0381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005992L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2157436000OtherBLUES
PA001470698OtherHIGHMARK BLUE CROSS/BLUE SHIELD
PA001470698OtherHIGHMARK BLUE CROSS/BLUE SHIELD