Provider Demographics
NPI:1205663424
Name:HOMETOWN SPINE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:HOMETOWN SPINE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-818-5597
Mailing Address - Street 1:250 MOUNT LEBANON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1252
Mailing Address - Country:US
Mailing Address - Phone:412-818-5597
Mailing Address - Fax:
Practice Address - Street 1:7231 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-3401
Practice Address - Country:US
Practice Address - Phone:412-818-5597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty