Provider Demographics
NPI:1295952885
Name:WELL ADJUSTED CHIROPRACTIC PC
Entity type:Organization
Organization Name:WELL ADJUSTED CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHFI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-941-3341
Mailing Address - Street 1:555 ANDORRA GLEN CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2531
Mailing Address - Country:US
Mailing Address - Phone:610-941-3341
Mailing Address - Fax:215-269-4873
Practice Address - Street 1:555 ANDORRA GLEN CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2531
Practice Address - Country:US
Practice Address - Phone:610-941-3341
Practice Address - Fax:215-269-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2451102000OtherPERSONAL CHOICE GRP ID #
PAWE1767919OtherHIGHMARK BLUE SHIELD