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General NPI Number Information
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NPI Number | 1467642793
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE & CHIROPRACTIC CENTERS, LLC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 850 W CHESTER PIKE STE 104
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City | HAVERTOWN
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State | PA
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Zip | 19083-4439
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Country | US
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Telephone | 484-480-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 425 FAYETTE ST UNIT 21
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-5400
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Country | US
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Telephone | 484-480-8400
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. WILLIAM W KIM
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Credential | DC
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Telephone | 484-480-8400
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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 | DC009631
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License Number State | PA
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