Provider Demographics
NPI:1023453065
Name:SPEIGLE CHIROPRACTIC, PC
Entity type:Organization
Organization Name:SPEIGLE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHMATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-742-1818
Mailing Address - Street 1:LANDMARK II BLDG. 20397 ROUTE 19N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6133
Mailing Address - Country:US
Mailing Address - Phone:724-742-1818
Mailing Address - Fax:724-742-1828
Practice Address - Street 1:20397 ROUTE 19N LANDMARK II BUILDING
Practice Address - Street 2:SUITE 120
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6133
Practice Address - Country:US
Practice Address - Phone:724-742-1818
Practice Address - Fax:724-742-1828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021998510002Medicaid
PA0091003ZEZ8OtherMEDICARE OF PA