Provider Demographics
NPI:1700903606
Name:ALTERNATIVE MEDICINE PAIN MANAGEMENT
Entity Type:Organization
Organization Name:ALTERNATIVE MEDICINE PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HABER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FACO,
Authorized Official - Phone:412-372-7900
Mailing Address - Street 1:2571 MOSSIDE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3576
Mailing Address - Country:US
Mailing Address - Phone:412-372-7900
Mailing Address - Fax:412-372-7911
Practice Address - Street 1:2571 MOSSIDE BLVD
Practice Address - Street 2:SUITE #3
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3576
Practice Address - Country:US
Practice Address - Phone:412-372-7900
Practice Address - Fax:412-372-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001169L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00631206Medicaid
PA00631206Medicaid