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General NPI Number Information
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NPI Number | 1699820886
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Entity Type | Organization
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Legal Business Name | THE FAMILY CHIROPRACTOR
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 270 N KESWICK AVE
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City | GLENSIDE
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State | PA
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Zip | 19038-4826
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Country | US
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Telephone | 215-572-1580
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Fax | 215-754-4917
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Provider Business Mailing Address
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Address Line | 270 N KESWICK AVE
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City | GLENSIDE
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State | PA
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Zip | 19038-4826
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Country | US
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Telephone | 215-572-1580
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Fax | 215-754-4917
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL J FARRELL
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Credential | DC
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Telephone | 215-572-1580
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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 | DC006126L
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License Number State | PA
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