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General NPI Number Information
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NPI Number | 1023212867
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Entity Type | Organization
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Legal Business Name | NON-SURGICAL BACK SOLUTIONS INC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4024 TYSON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19135-1608
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Country | US
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Telephone | 215-333-3322
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Fax | 215-333-6867
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Provider Business Mailing Address
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Address Line | 4024 TYSON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19135-1608
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Country | US
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Telephone | 215-333-3322
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Fax | 215-333-6867
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | LARRY MOSES
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Credential |
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Telephone | 215-333-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC002678L
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License Number State | PA
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