Provider Demographics
NPI:1023160967
Name:NESHAMINY VALLEY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:NESHAMINY VALLEY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRENINGHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-891-9955
Mailing Address - Street 1:2440 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-6002
Mailing Address - Country:US
Mailing Address - Phone:215-891-9955
Mailing Address - Fax:215-891-9655
Practice Address - Street 1:2440 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-6002
Practice Address - Country:US
Practice Address - Phone:215-891-9955
Practice Address - Fax:215-891-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007453L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07722886Medicaid
PA07722886Medicaid
PA046540Medicare ID - Type Unspecified