Provider Demographics
NPI:1528508140
Name:DR. JOHN'S CHIROPRACTIC
Entity type:Organization
Organization Name:DR. JOHN'S CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOFORIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-539-7333
Mailing Address - Street 1:3808 ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5256
Mailing Address - Country:US
Mailing Address - Phone:724-539-7333
Mailing Address - Fax:724-879-4531
Practice Address - Street 1:3808 ROUTE 30
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5256
Practice Address - Country:US
Practice Address - Phone:724-539-7333
Practice Address - Fax:724-879-4531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005829L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty