Provider Demographics
NPI:1740272657
Name:VACTOR, MICHAEL S (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:VACTOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PERRY HWY UNIT 104
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:PA
Mailing Address - Zip Code:16037-9200
Mailing Address - Country:US
Mailing Address - Phone:724-452-7304
Mailing Address - Fax:
Practice Address - Street 1:100 PERRY HWY UNIT 104
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:PA
Practice Address - Zip Code:16037-9200
Practice Address - Country:US
Practice Address - Phone:724-452-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007676L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA348455OtherBCBS
PA251879779OtherCOMMERCIAL PAYORS
PA348455OtherBCBS