Provider Demographics
NPI:1356767750
Name:SANSONE CHIROPRACTIC PC
Entity type:Organization
Organization Name:SANSONE CHIROPRACTIC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANSONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-327-0202
Mailing Address - Street 1:2812 GOLDEN MILE HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2400
Mailing Address - Country:US
Mailing Address - Phone:724-327-0202
Mailing Address - Fax:
Practice Address - Street 1:2812 GOLDEN MILE HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2400
Practice Address - Country:US
Practice Address - Phone:724-327-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty