Provider Demographics
NPI:1972033587
Name:SCALISE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:SCALISE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCALISE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-864-7447
Mailing Address - Street 1:12280 STATE ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-1820
Mailing Address - Country:US
Mailing Address - Phone:724-864-7447
Mailing Address - Fax:724-864-8022
Practice Address - Street 1:12280 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642
Practice Address - Country:US
Practice Address - Phone:724-864-7447
Practice Address - Fax:724-864-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-5162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1799260OtherTAX ID
PA0017498000002Medicaid