Provider Demographics
NPI:1023454311
Name:GEORGE'S CHIROPRACTIC TONAL ADJUSTING CENTER, INC
Entity type:Organization
Organization Name:GEORGE'S CHIROPRACTIC TONAL ADJUSTING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RISSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-806-5329
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:BART
Mailing Address - State:PA
Mailing Address - Zip Code:17503-0124
Mailing Address - Country:US
Mailing Address - Phone:717-806-5329
Mailing Address - Fax:717-806-5117
Practice Address - Street 1:18 C FURNACE ROAD
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566
Practice Address - Country:US
Practice Address - Phone:717-806-5329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004536L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU11275Medicare UPIN