Provider Demographics
NPI:1255549648
Name:YOUGH VALLEY CHIROPRACTIC,PC
Entity type:Organization
Organization Name:YOUGH VALLEY CHIROPRACTIC,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:V
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-935-9800
Mailing Address - Street 1:710 ODEN ST
Mailing Address - Street 2:
Mailing Address - City:CONFLUENCE
Mailing Address - State:PA
Mailing Address - Zip Code:15424-1036
Mailing Address - Country:US
Mailing Address - Phone:814-395-9800
Mailing Address - Fax:814-395-9803
Practice Address - Street 1:710 ODEN ST
Practice Address - Street 2:
Practice Address - City:CONFLUENCE
Practice Address - State:PA
Practice Address - Zip Code:15424-1036
Practice Address - Country:US
Practice Address - Phone:814-395-9800
Practice Address - Fax:814-395-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty