Healthcare Provider Details

I. General information

NPI: 1518918762
Provider Name (Legal Business Name): CHELTENHAM CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 W CHELTENHAM AVE
PHILADELPHIA PA
19126-1546
US

IV. Provider business mailing address

PO BOX 30030
ELKINS PARK PA
19027-0330
US

V. Phone/Fax

Practice location:
  • Phone: 215-782-8760
  • Fax: 215-635-7130
Mailing address:
  • Phone: 215-782-8760
  • Fax: 215-635-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StatePA

VIII. Authorized Official

Name: HUGH F BAYLINSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 215-782-8760