Provider Demographics
NPI:1356516041
Name:LAHODA CHIROPRACTIC CENTRE INC.
Entity type:Organization
Organization Name:LAHODA CHIROPRACTIC CENTRE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAHODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-364-0364
Mailing Address - Street 1:67 ALMSHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1105
Mailing Address - Country:US
Mailing Address - Phone:215-364-0364
Mailing Address - Fax:
Practice Address - Street 1:67 ALMSHOUSE RD
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1105
Practice Address - Country:US
Practice Address - Phone:215-364-0364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002846L111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA465303Medicare PIN