Provider Demographics
NPI:1366427254
Name:CHOICE CHIROPRACTIC AND WELLNESS CENTER
Entity type:Organization
Organization Name:CHOICE CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:L
Authorized Official - Last Name:THIEROFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-364-9699
Mailing Address - Street 1:8199 MCKNIGHT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5749
Mailing Address - Country:US
Mailing Address - Phone:412-364-9699
Mailing Address - Fax:412-364-5172
Practice Address - Street 1:8199 MCKNIGHT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5749
Practice Address - Country:US
Practice Address - Phone:412-364-9699
Practice Address - Fax:412-364-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007486L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty