Provider Demographics
NPI:1336265529
Name:A SPRINGDALE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:A SPRINGDALE CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOMANEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-699-1661
Mailing Address - Street 1:752 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3133
Mailing Address - Country:US
Mailing Address - Phone:717-699-1661
Mailing Address - Fax:717-699-1662
Practice Address - Street 1:752 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3133
Practice Address - Country:US
Practice Address - Phone:717-699-1661
Practice Address - Fax:717-699-1662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007067L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU68958Medicare UPIN
PA003436Medicare ID - Type UnspecifiedMEDICARE - PA