| Icarus Chiropractic Llc | |
|
210 6th St Suite 7 Clymer PA 15728-1257 | |
| (724) 422-8070 | |
| (724) 905-8084 |
| Full Name | Icarus Chiropractic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 210 6th St, Clymer, Pennsylvania |
| Authorized Official Name and Position | Johnathan Clark (OWNER) |
| Authorized Official Contact | 7244228070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icarus Chiropractic Llc 210 6th St Suite 7 Clymer PA 15728-1257 Ph: (724) 422-8070 | Icarus Chiropractic Llc 210 6th St Suite 7 Clymer PA 15728-1257 Ph: (724) 422-8070 |
| NPI Number | 1225492465 |
|---|---|
| Provider Enumeration Date | 04/13/2016 |
| Last Update Date | 06/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225492465 | NPI | - | NPPES |
| 504984 | Other | PA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC011132 (Pennsylvania) | Primary |
Russell Drozdiak Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 349 Franklin St, Clymer, PA 15728 Phone: 724-254-4134 Fax: 724-254-2350 |