Provider Demographics
NPI:1871778746
Name:JOHN A JOSEPH DC PC
Entity type:Organization
Organization Name:JOHN A JOSEPH DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DC PC
Authorized Official - Phone:814-943-3033
Mailing Address - Street 1:411 S LOGAN BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4101
Mailing Address - Country:US
Mailing Address - Phone:814-943-3033
Mailing Address - Fax:814-943-1210
Practice Address - Street 1:411 S LOGAN BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4101
Practice Address - Country:US
Practice Address - Phone:814-943-3033
Practice Address - Fax:814-943-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-0002521-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30112OtherUPIN
PAT30112OtherUPIN