Provider Demographics
NPI:1194927970
Name:DOCTOR V CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:DOCTOR V CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-787-0101
Mailing Address - Street 1:1111 OAKDALE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-1523
Mailing Address - Country:US
Mailing Address - Phone:412-787-0101
Mailing Address - Fax:412-787-0111
Practice Address - Street 1:1111 OAKDALE RD STE 1
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-1523
Practice Address - Country:US
Practice Address - Phone:412-787-0101
Practice Address - Fax:412-787-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005145-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019197210002Medicaid
PA11213773OtherCAQH PROV NUMBER
PA2385976OtherAETNA PROV. NUMBER
PA3529975OtherAETNA HMO NUMBER
PA705298OtherHIGHMARK BC BS GROUP
PA5680249OtherAETNA PPO NUMBER
PA705298OtherHIGHMARK BC BS GROUP
PAU36327Medicare UPIN
PA705298OtherHIGHMARK BC BS GROUP