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General NPI Number Information
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NPI Number | 1134427693
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Entity Type | Organization
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Legal Business Name | WYOMING CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 441 E WYOMING AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4541
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Country | US
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Telephone | 215-457-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 441 E WYOMIMG AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4541
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Country | US
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Telephone | 215-457-4422
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | MR. MUSA AJAJ
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Credential | D.C
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Telephone | 215-457-4422
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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 | DC006475L
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License Number State | PA
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