Provider Demographics
NPI:1245693019
Name:PITTSBURGH CHIROPRACTIC AND MASSAGE THERAPY CENTER
Entity type:Organization
Organization Name:PITTSBURGH CHIROPRACTIC AND MASSAGE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-983-1445
Mailing Address - Street 1:436 7TH AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-1826
Mailing Address - Country:US
Mailing Address - Phone:412-434-0790
Mailing Address - Fax:412-434-0791
Practice Address - Street 1:436 7TH AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-1826
Practice Address - Country:US
Practice Address - Phone:412-434-0790
Practice Address - Fax:412-434-0791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008984111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty