Provider Demographics
NPI:1255335790
Name:ERRIS, EDWARD M (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:M
Last Name:ERRIS
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 1:3 JAMES WAY
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-1547
Mailing Address - Country:US
Mailing Address - Phone:570-876-5558
Mailing Address - Fax:
Practice Address - Street 1:3 JAMES WAY
Practice Address - Street 2:
Practice Address - City:ARCHBALD
Practice Address - State:PA
Practice Address - Zip Code:18403-1547
Practice Address - Country:US
Practice Address - Phone:570-876-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002057-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29668Medicare UPIN
PA151468F2NMedicare ID - Type Unspecified