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General NPI Number Information
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NPI Number | 1053356576
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Entity Type | Organization
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Legal Business Name | WILLIAM M. TSOUBANOS, D.C.P.C.
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 815 FAYETTE ST
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-1785
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Country | US
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Telephone | 610-828-2500
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Fax | 610-834-7822
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Provider Business Mailing Address
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Address Line | 6011 SHEAFF LN
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-1814
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Country | US
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Telephone | 610-476-9711
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Fax |
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Authorized Official
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Title or Position | OWNER,PRESIDENT
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Name | DR. WILLIAM M. TSOUBANOS
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Credential | D.C.
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Telephone | 610-828-2500
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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 | DC002450L
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License Number State | PA
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