Healthcare Provider Details

I. General information

NPI: 1538263900
Provider Name (Legal Business Name): TRI-COUNTY CHIROPRACTIC OF DOUGLASSVILLE,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 BEN FRANKLIN HWY E
DOUGLASSVILLE PA
19518-9547
US

IV. Provider business mailing address

990 BEN FRANKLIN HWY E
DOUGLASSVILLE PA
19518-9547
US

V. Phone/Fax

Practice location:
  • Phone: 610-385-1444
  • Fax: 610-385-1441
Mailing address:
  • Phone: 610-385-1444
  • Fax: 610-385-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ERIN GRANT
Title or Position: MANAGER
Credential:
Phone: 610-385-1444