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General NPI Number Information
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NPI Number | 1467656173
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Entity Type | Organization
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Legal Business Name | ADVANCED CHIROPRACTIC OF PHILADELPHIA, PLLC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 1518 WALNUT ST STE 303
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3402
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Country | US
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Telephone | 215-545-5117
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Fax |
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Provider Business Mailing Address
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Address Line | 1518 WALNUT ST STE 303
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3402
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Country | US
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Telephone | 215-545-5117
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ALEXANDER JAMIESON
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Credential | D.C.
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Telephone | 215-545-5117
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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 | DC009114
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License Number State | PA
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