Provider Demographics
NPI:1154746915
Name:LABACH CHIROPRACTIC
Entity type:Organization
Organization Name:LABACH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LABACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-524-1362
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:112 PITTSBURGH ST
Mailing Address - City:SAXONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16056-0364
Mailing Address - Country:US
Mailing Address - Phone:724-524-1362
Mailing Address - Fax:724-524-1362
Practice Address - Street 1:112 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:SAXONBURG
Practice Address - State:PA
Practice Address - Zip Code:16056-9550
Practice Address - Country:US
Practice Address - Phone:724-524-1362
Practice Address - Fax:724-524-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty