Organization
PORTAGE CHIROPRACTIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M. HERALD D.C. (OWNER)
(814) 736-9897
Entity
Organization
Contact information
Practice address
808 CALDWELL AVE, SUITE 102, PORTAGE, PA 15946-1571
(814) 736-9897
Mailing address
808 CALDWELL AVE, SUITE 102, PORTAGE, PA 15946-1571
(814) 736-9897
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006906R
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001455340
BLUE CROSS BLUE SHIELD
PA
05
—
0016403170004
—
PA
01
—
303267
UPMC
PA
Enumeration date
01/11/2007
Last updated
05/17/2011
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