Provider Demographics
NPI:1689035115
Name:MADDAS CHIROPRACTIC & REHAB INC.
Entity type:Organization
Organization Name:MADDAS CHIROPRACTIC & REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-430-4924
Mailing Address - Street 1:870 MCCLELLANDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MC CLELLANDTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15458-1116
Mailing Address - Country:US
Mailing Address - Phone:724-430-4924
Mailing Address - Fax:724-430-4925
Practice Address - Street 1:870 MCCLELLANDTOWN RD
Practice Address - Street 2:
Practice Address - City:MC CLELLANDTOWN
Practice Address - State:PA
Practice Address - Zip Code:15458-1116
Practice Address - Country:US
Practice Address - Phone:724-430-4924
Practice Address - Fax:724-430-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA244038Medicare UPIN