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General NPI Number Information
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NPI Number | 1235679044
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Entity Type | Organization
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Legal Business Name | NORMAN MUDASIR DC PC
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 6000 N BROAD ST SUITE 1
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City | PHILADELPHIA
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State | PA
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Zip | 19141-1900
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Country | US
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Telephone | 215-424-4005
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 N BROAD ST SUITE 1
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City | PHILADELPHIA
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State | PA
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Zip | 19141-1900
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Country | US
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Telephone | 215-424-4005
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Fax |
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Authorized Official
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Title or Position | CLINICAL DOCTOR
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Name | DR. NORMAN MUDASIR
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Credential | D.C.
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Telephone | 215-424-4005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | DC009174
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License Number State | PA
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