Provider Demographics
NPI:1285892422
Name:HARRISON HILLS CHIROPRACTIC AND WELLNESSCENTER
Entity type:Organization
Organization Name:HARRISON HILLS CHIROPRACTIC AND WELLNESSCENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOSAFLOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-226-3507
Mailing Address - Street 1:4033 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1969
Mailing Address - Country:US
Mailing Address - Phone:724-226-3507
Mailing Address - Fax:
Practice Address - Street 1:4033 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1969
Practice Address - Country:US
Practice Address - Phone:724-226-3507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABC-6332-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100762Medicare PIN