Provider Demographics
NPI:1427497635
Name:GREENSBURG CHIROPRACTIC LLC
Entity type:Organization
Organization Name:GREENSBURG CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-836-2200
Mailing Address - Street 1:106 WESTPOINT DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5965
Mailing Address - Country:US
Mailing Address - Phone:724-836-2200
Mailing Address - Fax:
Practice Address - Street 1:106 WESTPOINT DR
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5965
Practice Address - Country:US
Practice Address - Phone:724-836-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty