Provider Demographics
NPI:1962570176
Name:KRAUZA FAMILY CHIROPRACTIC, INC
Entity type:Organization
Organization Name:KRAUZA FAMILY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRAUZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-898-2346
Mailing Address - Street 1:4190 E LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-1355
Mailing Address - Country:US
Mailing Address - Phone:814-898-2346
Mailing Address - Fax:814-899-6650
Practice Address - Street 1:4190 E LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16511-1355
Practice Address - Country:US
Practice Address - Phone:814-898-2346
Practice Address - Fax:814-899-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008982360002Medicaid
PA1770546376OtherPROVIDER'S NPI
PA1770546376OtherPROVIDER'S NPI
PAU97482Medicare UPIN