Provider Demographics
NPI:1255395075
Name:MONROEVILLE CHIROPRACTIC HEALTH CENTER, PC
Entity type:Organization
Organization Name:MONROEVILLE CHIROPRACTIC HEALTH CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-372-3762
Mailing Address - Street 1:4400 OLD WILLIAM PENN HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1480
Mailing Address - Country:US
Mailing Address - Phone:412-372-3762
Mailing Address - Fax:412-372-3761
Practice Address - Street 1:4400 OLD WILLIAM PENN HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1480
Practice Address - Country:US
Practice Address - Phone:412-372-3762
Practice Address - Fax:412-372-3761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007947L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU87242Medicare UPIN