Provider Demographics
NPI:1750699120
Name:KLUMP CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:KLUMP CHIROPRACTIC CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:KLUMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-697-1271
Mailing Address - Street 1:6301 FORBES AVE
Mailing Address - Street 2:SUITE #104
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1725
Mailing Address - Country:US
Mailing Address - Phone:412-697-1271
Mailing Address - Fax:412-697-1274
Practice Address - Street 1:6301 FORBES AVE
Practice Address - Street 2:SUITE #104
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1725
Practice Address - Country:US
Practice Address - Phone:412-697-1271
Practice Address - Fax:412-697-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1657612OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA1011768162002Medicaid
PA1657612OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA165865Medicare PIN