Provider Demographics
NPI:1356942940
Name:GEORGE, MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 SOLOMON RUN RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-7106
Mailing Address - Country:US
Mailing Address - Phone:814-421-7714
Mailing Address - Fax:
Practice Address - Street 1:1075 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4863
Practice Address - Country:US
Practice Address - Phone:724-837-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13280111N00000X
PAAJ011304111NR0400X
PADC011675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation