Provider Demographics
NPI:1124174842
Name:KRANTZ CHIROPRACTIC AND WELLNESS CENTER LTD
Entity type:Organization
Organization Name:KRANTZ CHIROPRACTIC AND WELLNESS CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-222-9555
Mailing Address - Street 1:4088 SKIPPACK PIKE
Mailing Address - Street 2:PO BOX 159
Mailing Address - City:SKIPPACK
Mailing Address - State:PA
Mailing Address - Zip Code:19474-0159
Mailing Address - Country:US
Mailing Address - Phone:610-222-9555
Mailing Address - Fax:610-222-9556
Practice Address - Street 1:4088 SKIPPACK PIKE
Practice Address - Street 2:
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474-0159
Practice Address - Country:US
Practice Address - Phone:610-222-9555
Practice Address - Fax:610-222-9556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005885L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001643574OtherHIGHMARK BLUE SHIELD
PA2324233000OtherINDEPENDENCE BLUE CROSS
PA016174Medicare UPIN