Healthcare Provider Details

I. General information

NPI: 1316992233
Provider Name (Legal Business Name): ELEFTHERIOS TOURLITIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 CONCHESTER HWY SUITES 9-10
ASTON PA
19014-3129
US

IV. Provider business mailing address

478 CONCHESTER HWY SUITES 9-10
ASTON PA
19014-3129
US

V. Phone/Fax

Practice location:
  • Phone: 610-497-9151
  • Fax: 610-497-9153
Mailing address:
  • Phone: 610-497-9151
  • Fax: 610-497-9153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007196L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: