Healthcare Provider Details

I. General information

NPI: 1942554399
Provider Name (Legal Business Name): JAMISON CHIROPRACTIC CORPORATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 ALMSHOUSE RD
JAMISON PA
18929-1002
US

IV. Provider business mailing address

1703 ALMSHOUSE RD
JAMISON PA
18929-1002
US

V. Phone/Fax

Practice location:
  • Phone: 215-343-4036
  • Fax:
Mailing address:
  • Phone: 215-343-4036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007020L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC007190L
License Number StatePA

VIII. Authorized Official

Name: DR. MARK JOSEPH FEENEY
Title or Position: PARTNER
Credential: D.C.
Phone: 215-343-4036