Provider Demographics
NPI:1811951338
Name:PHILLIPS FAMILY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:PHILLIPS FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:S
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-287-2837
Mailing Address - Street 1:120 HOLLYWOOD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-7604
Mailing Address - Country:US
Mailing Address - Phone:724-287-2837
Mailing Address - Fax:724-287-0496
Practice Address - Street 1:120 HOLLYWOOD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-7604
Practice Address - Country:US
Practice Address - Phone:724-287-2837
Practice Address - Fax:724-287-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004388L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1626102OtherHIGHMARK
DC1260OtherRR MEDICARE
DC1260OtherRR MEDICARE