Healthcare Provider Details

I. General information

NPI: 1760532873
Provider Name (Legal Business Name): ARLENE TILSON-CHRYSLER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7622 OGONTZ AVE
PHILADELPHIA PA
19150-1817
US

IV. Provider business mailing address

7622 OGONTZ AVE
PHILADELPHIA PA
19150-1817
US

V. Phone/Fax

Practice location:
  • Phone: 215-224-8980
  • Fax: 215-224-9342
Mailing address:
  • Phone: 215-224-8980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-006238
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX011255
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: