Active Life Chiropractic
Organization Active NPI Chiropractor · York, PA
NPI 1184928871 · NPPES record last updated Dec 7, 2011
Key facts
- NPI
- 1184928871
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC007961L (PA)
- Legal business name
- ACTIVE LIFE CHIROPRACTIC
- Practice address
- 1915 E Market St
York, PA 17402-2839 - Phone
- (717) 751-0500
- Fax
- (717) 814-5407
- NPI assigned
- Jan 10, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Nichole Ann Lehman, D.C.
- Title
- Owner
- Phone
- (717) 751-0500
Corporate family (same tax ID) 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110412000047 | PA | Part B Supplier - Clinic/Group Practice | 3870777162 |
Receives reassigned benefits from 1 practitioner Practice locations: Camp Hill, PA; York, PA |
National Provider Directory
- Tax ID family
- Active Life Chiropctic
Locations
1900 E Market St
Ste 2
York, PA 17402
Phone (717) 751-0500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC007961L | PA | Yes |
Addresses
Primary practice location
1915 E Market St
York, PA 17402-2839
Mailing address
1915 E Market St
York, PA 17402-2839
Phone (717) 751-0500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209146 | Other | PA | MEDICARE PTAN |
Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.