Provider Demographics
NPI:1366887374
Name:TROOPER CHIROPRACTIC & REHABILITATION
Entity type:Organization
Organization Name:TROOPER CHIROPRACTIC & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-650-0969
Mailing Address - Street 1:2584 STINSON LN
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3664
Mailing Address - Country:US
Mailing Address - Phone:610-650-0969
Mailing Address - Fax:610-650-8242
Practice Address - Street 1:2584 STINSON LN
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3664
Practice Address - Country:US
Practice Address - Phone:610-650-0969
Practice Address - Fax:610-650-8242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004751L111NP0017X, 111NN0400X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAJ050365Medicare UPIN
PA2374918Medicare UPIN
PA2416173Medicare UPIN