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General NPI Number Information
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NPI Number | 1093994964
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Entity Type | Organization
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Legal Business Name | EAST FALLS CHIROPRACTIC, INC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 3425 CONRAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1636
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Country | US
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Telephone | 215-849-3700
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Fax | 215-849-3744
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Provider Business Mailing Address
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Address Line | 3425 CONRAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1636
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Country | US
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Telephone | 215-849-3700
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Fax | 215-849-3744
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Authorized Official
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Title or Position | OWNER
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Name | STUART E KATZEN
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Credential | DC
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Telephone | 215-849-3700
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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 | 007357L
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License Number State | PA
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