Provider Demographics
NPI:1750530366
Name:ACKERMAN CHIROPRACTIC SERVICES PC
Entity type:Organization
Organization Name:ACKERMAN CHIROPRACTIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-353-4433
Mailing Address - Street 1:724 CEDAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-2219
Mailing Address - Country:US
Mailing Address - Phone:610-353-4433
Mailing Address - Fax:610-353-5198
Practice Address - Street 1:724 CEDAR GROVE RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-2219
Practice Address - Country:US
Practice Address - Phone:610-353-4433
Practice Address - Fax:610-353-5198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA081030551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000099026OtherHIGHMARK BLUE SHIELD
PA0032856000OtherINDEPENDANCE BLUE CROSS
PA54591OtherAETNA HMO
PA4310067OtherAETNA
PA54591OtherAETNA HMO