Healthcare Provider Details

I. General information

NPI: 1205901303
Provider Name (Legal Business Name): PAUL LOUIS SBARRA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 MOORE ST
PHILADELPHIA PA
19148-1516
US

IV. Provider business mailing address

2224 S CLARION ST
PHILADELPHIA PA
19148-2918
US

V. Phone/Fax

Practice location:
  • Phone: 215-271-0318
  • Fax: 215-271-0319
Mailing address:
  • Phone: 267-237-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007573L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: