Provider Demographics
NPI:1952501991
Name:ELSIE J. WENRICH
Entity Type:Organization
Organization Name:ELSIE J. WENRICH
Other - Org Name:LESLIE W WENRICH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELSIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WENRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-647-4955
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:TOWER CITY
Mailing Address - State:PA
Mailing Address - Zip Code:17980-0026
Mailing Address - Country:US
Mailing Address - Phone:717-647-4955
Mailing Address - Fax:717-647-9064
Practice Address - Street 1:424 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:TOWER CITY
Practice Address - State:PA
Practice Address - Zip Code:17980-1018
Practice Address - Country:US
Practice Address - Phone:717-647-4955
Practice Address - Fax:717-647-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA073008OtherMEDICARE PROVIDER NUMBER