Provider Demographics
NPI:1720449911
Name:SHENANGO VALLEY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:SHENANGO VALLEY CHIROPRACTIC PC
Other - Org Name:MORRIS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-981-5551
Mailing Address - Street 1:2500 HIGHLAND RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4601
Mailing Address - Country:US
Mailing Address - Phone:724-981-5551
Mailing Address - Fax:724-981-5552
Practice Address - Street 1:2500 HIGHLAND RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4601
Practice Address - Country:US
Practice Address - Phone:724-981-5551
Practice Address - Fax:724-981-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-08000-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U89104Medicare UPIN