Provider Demographics
NPI:1831354406
Name:ADVANCED CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:ADVANCED CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHOENLY
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:215-679-5915
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:RED HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18076-0272
Mailing Address - Country:US
Mailing Address - Phone:215-679-5915
Mailing Address - Fax:215-679-6467
Practice Address - Street 1:326 MAIN ST
Practice Address - Street 2:
Practice Address - City:RED HILL
Practice Address - State:PA
Practice Address - Zip Code:18076-1459
Practice Address - Country:US
Practice Address - Phone:215-679-5915
Practice Address - Fax:215-679-6467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002925L261QM2500X
PADC009959261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T30561Medicare UPIN