Provider Demographics
NPI:1023493400
Name:PIKULIN CHIROPRATIC CENTER
Entity type:Organization
Organization Name:PIKULIN CHIROPRATIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:PIKULIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-774-5166
Mailing Address - Street 1:221 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-2127
Mailing Address - Country:US
Mailing Address - Phone:717-774-5166
Mailing Address - Fax:717-774-6355
Practice Address - Street 1:221 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-2127
Practice Address - Country:US
Practice Address - Phone:717-774-5166
Practice Address - Fax:717-774-6355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002863L-AJ002363L111NS0005X
PADC001353L-AJ001353P111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU01340Medicare PIN
PAT28903Medicare UPIN