Provider Demographics
NPI:1871707455
Name:CHIROPRACTIC NORTH
Entity type:Organization
Organization Name:CHIROPRACTIC NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-939-3222
Mailing Address - Street 1:101 BELLEVUE RD
Mailing Address - Street 2:SUITE 01
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-2125
Mailing Address - Country:US
Mailing Address - Phone:412-939-3222
Mailing Address - Fax:412-939-3415
Practice Address - Street 1:101 BELLEVUE RD
Practice Address - Street 2:SUITE 01
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229-2125
Practice Address - Country:US
Practice Address - Phone:412-939-3222
Practice Address - Fax:412-939-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 002293L111N00000X
PAAJ 002293-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA317906OtherUPMC ID
PA334150OtherHIGHMARK GROUP ID
PA2998457OtherAETNA ID
PA334150OtherHIGHMARK GROUP ID
PA416931Medicare ID - Type Unspecified