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General NPI Number Information
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NPI Number | 1538518063
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Entity Type | Organization
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Legal Business Name | METRO HEALTH AND WELLNESS
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 6404 ROOSEVELT BLVD STE 1C
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2943
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Country | US
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Telephone | 215-904-5252
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Fax | 215-437-1407
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Provider Business Mailing Address
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Address Line | 6404 ROOSEVELT BLVD STE 1C
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2943
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Country | US
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Telephone | 215-904-5252
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Fax | 215-437-1407
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Authorized Official
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Title or Position | PRESIDENT
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Name | WAYNE OLIVER
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Credential |
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Telephone | 215-904-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 073752
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License Number State | PA
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