MEDICARE: TRIUNE CHIROPRACTIC COUNSELING AND WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC006960L	PA

General Provider Information

NPI Number	:	1164527602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUNE CHIROPRACTIC COUNSELING AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	325 CHERRY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-1815
Country	:	US
Telephone Number	:	215-627-6279
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 CHERRY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-1815
Country	:	US
Telephone Number	:	215-627-6279
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFFREY A SKLAR
Credential	:	D.C.
Telephone Number	:	215-627-6279

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/22/2020

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