Provider Demographics
NPI:1730364670
Name:HUNTINGDON CHIROPRACTIC CENTER P.C.
Entity type:Organization
Organization Name:HUNTINGDON CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-643-1900
Mailing Address - Street 1:302 WILLIAM SMITH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1416
Mailing Address - Country:US
Mailing Address - Phone:814-643-1900
Mailing Address - Fax:814-643-2687
Practice Address - Street 1:302 WILLIAM SMITH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1416
Practice Address - Country:US
Practice Address - Phone:814-643-1900
Practice Address - Fax:814-643-2687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010549190001Medicaid
PA428751Medicare PIN