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General NPI Number Information
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NPI Number | 1053486779
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Entity Type | Organization
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Legal Business Name | JENKINTOWN CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 435 JOHNSON ST
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City | JENKINTOWN
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State | PA
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Zip | 19046-2705
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Country | US
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Telephone | 215-885-8730
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Fax | 215-885-7665
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Provider Business Mailing Address
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Address Line | 435 JOHNSON ST
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City | JENKINTOWN
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State | PA
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Zip | 19046-2705
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Country | US
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Telephone | 215-885-8730
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Fax | 215-885-7665
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STUART B. TOLLEN
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Credential | D.C.
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Telephone | 215-885-8730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | DC004405L
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License Number State | PA
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