Healthcare Provider Details

I. General information

NPI: 1336701036
Provider Name (Legal Business Name): DANIEL RUFUS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 HOLME AVE
PHILADELPHIA PA
19152-2118
US

IV. Provider business mailing address

2875 HOLME AVE
PHILADELPHIA PA
19152-2118
US

V. Phone/Fax

Practice location:
  • Phone: 215-673-1113
  • Fax: 215-673-4941
Mailing address:
  • Phone: 215-673-1113
  • Fax: 215-673-4941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC011890
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF1-0000992
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: