Provider Demographics
NPI:1386762177
Name:HERMAN CHIROPRACTIC CENTER OF LEBANON, INC.
Entity type:Organization
Organization Name:HERMAN CHIROPRACTIC CENTER OF LEBANON, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROSINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-564-4151
Mailing Address - Street 1:700 S POTOMAC ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-2198
Mailing Address - Country:US
Mailing Address - Phone:717-762-1773
Mailing Address - Fax:717-762-8544
Practice Address - Street 1:6301 GRAYSON RD
Practice Address - Street 2:SPACE A-130
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-3331
Practice Address - Country:US
Practice Address - Phone:717-564-4151
Practice Address - Fax:717-564-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-009549111N00000X
PAAJ-009350111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARO1845849OtherHIGHMARK
PAV08868Medicare UPIN
PARO1845849OtherHIGHMARK