Provider Demographics
NPI:1063590933
Name:BLACKHAWK CHIROPRACTIC,INC
Entity type:Organization
Organization Name:BLACKHAWK CHIROPRACTIC,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-827-2400
Mailing Address - Street 1:3602 DARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16115-2524
Mailing Address - Country:US
Mailing Address - Phone:724-827-2400
Mailing Address - Fax:724-827-2500
Practice Address - Street 1:3602 DARLINGTON RD
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:PA
Practice Address - Zip Code:16115-2524
Practice Address - Country:US
Practice Address - Phone:724-827-2400
Practice Address - Fax:724-827-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC05395L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty