Healthcare Provider Details
I. General information
NPI: 1992459887
Provider Name (Legal Business Name): HAVERFORD COMPREHENSIVE WELLNESS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2022
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7592 HAVERFORD AVE
PHILADELPHIA PA
19151-2113
US
IV. Provider business mailing address
PO BOX 1701
SOUTHAMPTON PA
18966-0814
US
V. Phone/Fax
- Phone: 215-879-4422
- Fax:
- Phone: 215-879-4422
- Fax: 215-879-4433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
M
DELFINER
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 215-879-4422