Provider Demographics
NPI:1891119384
Name:HANDS FOR HEALTH FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:HANDS FOR HEALTH FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:717-558-8110
Mailing Address - Street 1:7841 PAXTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-5426
Mailing Address - Country:US
Mailing Address - Phone:717-558-8110
Mailing Address - Fax:717-558-8115
Practice Address - Street 1:7841 PAXTON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-5426
Practice Address - Country:US
Practice Address - Phone:717-558-8110
Practice Address - Fax:717-558-8115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1346423456OtherMEDICARE INDIVIDUAL NPI
PA135370OtherMEDICARE PTAN