Provider Demographics
NPI:1558536599
Name:ALLEGHENY SPINE & WELLNESS CENTER
Entity type:Organization
Organization Name:ALLEGHENY SPINE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:VERBANICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-672-5848
Mailing Address - Street 1:1217 LONG RUN RD
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2034
Mailing Address - Country:US
Mailing Address - Phone:412-672-5848
Mailing Address - Fax:412-672-5851
Practice Address - Street 1:1217 LONG RUN RD
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15131-2034
Practice Address - Country:US
Practice Address - Phone:412-672-5848
Practice Address - Fax:412-672-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007484L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA076563Medicare PIN
PAU79488Medicare UPIN