Provider Demographics
NPI:1649499211
Name:LIMERICK CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:LIMERICK CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-489-1000
Mailing Address - Street 1:332 W RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1718
Mailing Address - Country:US
Mailing Address - Phone:610-489-1000
Mailing Address - Fax:610-489-5966
Practice Address - Street 1:332 W RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1718
Practice Address - Country:US
Practice Address - Phone:610-489-1000
Practice Address - Fax:610-489-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004676-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU18949Medicare UPIN
PABA675561Medicare ID - Type Unspecified