Provider Demographics
NPI:1134187180
Name:RUMBAUGH, ALLAN J (DC)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:J
Last Name:RUMBAUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 N PORTER ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1427
Mailing Address - Country:US
Mailing Address - Phone:724-852-1624
Mailing Address - Fax:724-852-1592
Practice Address - Street 1:35 N PORTER ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1427
Practice Address - Country:US
Practice Address - Phone:724-852-1624
Practice Address - Fax:724-852-1592
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003787L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017736810001Medicaid
PA209876OtherUPMC
PA542285OtherHIGHMARK
PA542285OtherHIGHMARK
PA209876OtherUPMC