Provider Demographics
NPI:1902072069
Name:CECIL CHIROPRACTIC
Entity Type:Organization
Organization Name:CECIL CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:412-220-1800
Mailing Address - Street 1:3131 MILLERS RUN RD
Mailing Address - Street 2:
Mailing Address - City:CECIL
Mailing Address - State:PA
Mailing Address - Zip Code:15321-1264
Mailing Address - Country:US
Mailing Address - Phone:412-220-1800
Mailing Address - Fax:412-220-2400
Practice Address - Street 1:3131 MILLERS RUN RD
Practice Address - Street 2:
Practice Address - City:CECIL
Practice Address - State:PA
Practice Address - Zip Code:15321-1264
Practice Address - Country:US
Practice Address - Phone:412-220-1800
Practice Address - Fax:412-220-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA201941OtherUPMC
PA5641675OtherAETNA
PA7518611OtherCIGNA
PAOO1669899Medicaid
PA715018OtherBLUE CROSS BLUE SHIELD
PA664743OtherUNITED
PA764457Medicare PIN