Provider Demographics
NPI:1265481071
Name:SUCCESS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SUCCESS CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-337-3700
Mailing Address - Street 1:198 ALLENDALE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2925
Mailing Address - Country:US
Mailing Address - Phone:610-337-3700
Mailing Address - Fax:
Practice Address - Street 1:198 ALLENDALE RD STE 201
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2925
Practice Address - Country:US
Practice Address - Phone:610-337-3700
Practice Address - Fax:610-489-4706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003552L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
543779OtherHIGHMARK BS
0865929000OtherIBC
543779OtherHIGHMARK BS