MEDICARE: CHIROPRACTIC REHABILITATION & WELLNESS CENTER, 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	DC009421	PA

General Provider Information

NPI Number	:	1720380983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC REHABILITATION & WELLNESS CENTER, LLC

Provider Business Mailing Address
First Line	:	3370 MEMPHIS ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4510
Country	:	US
Telephone Number	:	267-324-3156
Fax Number	:	267-324-3195

Provider Business Practice Location Address
First Line	:	3370 MEMPHIS ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4510
Country	:	US
Telephone Number	:	267-324-3156
Fax Number	:	267-324-3195

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. EMILY AURAND SWONGUER
Credential	:	D.C.
Telephone Number	:	267-324-3156

Provider Enumeration Date	:	11/21/2010
Last Update Date	:	12/20/2010

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