Healthcare Provider Details

I. General information

NPI: 1548214737
Provider Name (Legal Business Name): GREATER PHILADELPHIA CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2612 RHAWN ST
PHILADELPHIA PA
19152-3415
US

IV. Provider business mailing address

2612 RHAWN ST
PHILADELPHIA PA
19152-3415
US

V. Phone/Fax

Practice location:
  • Phone: 215-338-8555
  • Fax: 215-338-8031
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-005865-L
License Number StatePA

VIII. Authorized Official

Name: DR. FRANCIS EDWARD BRADY
Title or Position: OWNER
Credential: D.C.
Phone: 215-338-8555