Organization
DIANA CHIROPRACTIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH DAVID DIANA DC (PRESIDENT)
(570) 455-8141
Entity
Organization
Contact information
Practice address
1056 GRANT ST, HAZLETON, PA 18202-1707
(570) 455-8141
(570) 455-8153
Mailing address
1056 GRANT ST, HAZLETON, PA 18202-1707
(570) 455-8141
(570) 455-8153
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017511560001
—
PA
01
—
130905
BLUE SHIELD
PA
Enumeration date
09/21/2007
Last updated
09/21/2007
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