Provider Demographics
NPI:1700595790
Name:AFFINITY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:AFFINITY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-693-3730
Mailing Address - Street 1:1962 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8384
Mailing Address - Country:US
Mailing Address - Phone:814-693-3730
Mailing Address - Fax:814-693-2160
Practice Address - Street 1:1962 PLANK RD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8384
Practice Address - Country:US
Practice Address - Phone:814-693-3730
Practice Address - Fax:814-693-2160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty