Healthcare Provider Details

I. General information

NPI: 1265481071
Provider Name (Legal Business Name): SUCCESS CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 ALLENDALE RD STE 201
KING OF PRUSSIA PA
19406-2925
US

IV. Provider business mailing address

198 ALLENDALE RD STE 201
KING OF PRUSSIA PA
19406-2925
US

V. Phone/Fax

Practice location:
  • Phone: 610-337-3700
  • Fax: 610-489-4706
Mailing address:
  • Phone: 610-337-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC003552L
License Number StatePA

VIII. Authorized Official

Name: DR. STEVE FLEISHER
Title or Position: OWNER
Credential: D.C.
Phone: 610-337-3700