Provider Demographics
NPI:1487183331
Name:WHOLE HEALTH JOINT REPLACEMENT INSTITUTE, PLLC
Entity type:Organization
Organization Name:WHOLE HEALTH JOINT REPLACEMENT INSTITUTE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCKINNON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:814-333-7109
Mailing Address - Street 1:321 ARCH STREET
Mailing Address - Street 2:STE 101
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3214
Mailing Address - Country:US
Mailing Address - Phone:814-333-7109
Mailing Address - Fax:814-333-7108
Practice Address - Street 1:321 ARCH STREET
Practice Address - Street 2:STE 101
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3214
Practice Address - Country:US
Practice Address - Phone:814-333-7109
Practice Address - Fax:814-333-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103306590Medicaid