Healthcare Provider Details

I. General information

NPI: 1023211893
Provider Name (Legal Business Name): PINNACLE REHAB CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 W NEDRO AVE
PHILADELPHIA PA
19120-2458
US

IV. Provider business mailing address

199 W NEDRO AVE
PHILADELPHIA PA
19120-2458
US

V. Phone/Fax

Practice location:
  • Phone: 215-548-0202
  • Fax: 215-548-0324
Mailing address:
  • Phone: 215-548-0202
  • Fax: 215-548-0324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005297L
License Number StatePA

VIII. Authorized Official

Name: DR. WILLIAM M. BURSE
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 215-548-0202