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General NPI Number Information
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NPI Number | 1043397037
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Entity Type | Organization
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Legal Business Name | AMERICAN CLINIC OF CHIROPRACTIC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 1 E BEACON LIGHT LN
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City | CHESTER
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State | PA
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Zip | 19013-4433
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Country | US
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Telephone | 267-582-0056
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 115
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City | FOLSOM
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State | PA
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Zip | 19033-0115
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Country | US
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Telephone | 267-582-0056
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Fax | 610-490-3904
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | CHARLES J GRIM
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Credential |
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Telephone | 267-582-0056
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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 |
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License Number State |
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