Provider Demographics
NPI:1588749113
Name:HORNICKEL CHIROPRACTIC CLINIC, PC
Entity type:Organization
Organization Name:HORNICKEL CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-228-8600
Mailing Address - Street 1:132 E MAIDEN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4914
Mailing Address - Country:US
Mailing Address - Phone:724-228-8600
Mailing Address - Fax:724-228-8690
Practice Address - Street 1:132 E MAIDEN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4914
Practice Address - Country:US
Practice Address - Phone:724-228-8600
Practice Address - Fax:724-228-8690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004674-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty