STRUCTURAL DISORDERS OF THE SPINE (NPI# 1902853070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902853070 |
| Entity Type | Organization |
| Organization Name | STRUCTURAL DISORDERS OF THE SPINE |
| Practice Address |
21 North 4th Street Harrisburg PA 17101 |
| Practice Telephone | 7172333476 |
| Practice Fax Number | 7177962409 |
| Mailing Telephone | 7172333476 |
| Mailing Fax Number | 7177962409 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JASON MICHAEL FULLMER (OWNER) |
| Authorized Official Telephone | 7174603422 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 009494 | PA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CAPITAL BLUE CROSS | 50058252 | 01 |
| PA | HIGHMARK | FU1813015 | 01 |
| Street Address |
21 NORTH 4TH STREET |
| City | HARRISBURG |
| State | PA |
| Zip Code | 17101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417985227 | Jason Michael Fullmer | Chiropractor | 21 North 4th Street, Harrisburg, PA 17101 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689169906 | Seth Lascurain | Genetic Counselor, MS | 100 S. Second St., Suite 4b, Harrisburg, PA 17101 | 2018-06-28 |
| 1912347774 | Esther Chinedu Enu | Internal Medicine | 205 S. Front St, Harrisburg, PA 17101 | 2013-06-26 |
| 1881922599 | Abha Yadav | Pediatrics | Lpaharr Pinnacle Health-harrisbrg, Harrisbrg, PA 17101 | 2009-11-19 |
| 1467665158 | Kara Lynn Foulds | Pharmacist | 100-103 Market St, Harrisburg, PA 17101 | 2007-05-08 |
| 1588767339 | Pennsylvania Cvs Pharmacy LLC | Pharmacy | 221 223 E Market, Harrisburg, PA 17101 | 2006-09-07 |
| 1467415364 | Ndlovu Women's Health | Specialist | 100 South Second St, Medical Sciences Bldg Suite 4a, Harrisburg, PA 17101 | 2006-04-11 |
| 1710976899 | Michael Muench | Obstetrics & Gynecology | 100 S 2nd St Ste 4b, Harrisburg, PA 17101 | 2005-10-20 |
| 1053312371 | Linda Brooks Uchal | Pharmacist | 111 S. Front St., Pinnacle Health System, Harrisburg, PA 17101 | 2005-08-09 |
| 1487659355 | Elizabeth S. Klinke | Pediatrics | Harrisburg Hospital, Pediatrics Dept-nicu, 111 S Front St., Harrisburg, PA 17101 | 2005-06-16 |
| 1063020808 | Julie Haracz | Nurse Practitioner | 111 S Front Street, Harrisburg, PA 17101 | 2020-07-17 |
| Find all providers in zip 17101 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992357347 | Love Chiropractic Center Harrisburg, Inc. | Chiropractor | 175 Sims Pkwy, Harrisburg, NC 28075-7627 | 2019-07-15 |
| 1891119384 | Hands for Health Family Chiropractic LLC | Chiropractor | 7841 Paxton St, Harrisburg, PA 17111-5426 | 2014-02-05 |
| 1316293855 | Steward Chiropractic Center, LLC | Chiropractor | 608 Rollie Moore Dr., Suite 2, Harrisburg, IL 62946 | 2012-08-02 |
| 1023314986 | Matthew L Richardson | Chiropractor | 4400 Linglestown Rd 108, Harrisburg, PA 17112-8534 | 2011-02-09 |
| 1295054005 | Family First Chiropractic, LLC | Chiropractor | 4400 Linglestown Rd, Suite 108, Harrisburg, PA 17112-8507 | 2010-05-19 |
| 1982838710 | Bradley Dahlem Harryman | Chiropractor | 4456 Oakhurst Blvd, Harrisburg, PA 17110 | 2009-05-07 |
| 1215177183 | Schappell Chiropractic, PC | Chiropractor | 3301 Schoolhouse Lane, Harrisburg, PA 17109 | 2009-03-04 |
| 1649417684 | Luke Badman | Chiropractor | 7015 Jonestown Rd, Harrisburg, PA 17112-3613 | 2009-01-13 |
| 1407027535 | William David Levan | Chiropractor | 1000 Briarsdale Rd, Suite B, Harrisburg, PA 17109-5900 | 2008-03-17 |
| 1700060811 | Harrisburg Family Chiropractic PC | Chiropractor | 303 W Willow St, Harrisburg, SD 57032-2004 | 2007-12-26 |
| Find all providers in HARRISBURG | ||||
| City | HARRISBURG |
| Zip Code | 17101 |
Please comment or provide details below to improve the information on STRUCTURAL DISORDERS OF THE SPINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.