Provider Demographics
NPI:1811549009
Name:WILKES BARRE SCRANTON CHIROPRACTIC AND REHABILITATION
Entity type:Organization
Organization Name:WILKES BARRE SCRANTON CHIROPRACTIC AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-660-8914
Mailing Address - Street 1:98 GROVE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:PA
Mailing Address - Zip Code:18641-2228
Mailing Address - Country:US
Mailing Address - Phone:570-431-3404
Mailing Address - Fax:570-451-3407
Practice Address - Street 1:3 W OLIVE ST STE 210
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2574
Practice Address - Country:US
Practice Address - Phone:570-451-3404
Practice Address - Fax:570-451-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty