Healthcare Provider Details

I. General information

NPI: 1528071834
Provider Name (Legal Business Name): OCCUPATIONAL INDUSTRIAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S 17TH ST SUITE 2001
PHILADELPHIA PA
19103-6231
US

IV. Provider business mailing address

255 SOUTH 17TH STREET SUITE 2001
PHILADELPHIA PA
19143
US

V. Phone/Fax

Practice location:
  • Phone: 215-546-7049
  • Fax: 215-546-8646
Mailing address:
  • Phone: 215-546-7049
  • Fax: 215-546-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY ALLEN NELSON
Title or Position: CEO
Credential: M.D.
Phone: 215-546-7049