Provider Demographics
NPI:1174616858
Name:ULERY CHIROPRACTIC
Entity type:Organization
Organization Name:ULERY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ULERY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-887-4661
Mailing Address - Street 1:109 CROSSROADS RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-2458
Mailing Address - Country:US
Mailing Address - Phone:724-887-4661
Mailing Address - Fax:724-887-3329
Practice Address - Street 1:109 CROSSROADS RD
Practice Address - Street 2:SUITE 206
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-2458
Practice Address - Country:US
Practice Address - Phone:724-887-4661
Practice Address - Fax:724-887-3329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005213L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU39530Medicare UPIN
PA438713Medicare ID - Type Unspecified