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General NPI Number Information
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NPI Number | 1801032891
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Entity Type | Organization
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Legal Business Name | PROCARE REHAB, P.C.
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 1335 W TABOR RD STE 211
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3040
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Country | US
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Telephone | 215-276-1100
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Fax | 215-276-0277
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Provider Business Mailing Address
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Address Line | PO BOX 1961
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City | PHILADELPHIA
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State | PA
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Zip | 19105-1961
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Country | US
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Telephone | 215-276-1100
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Fax | 215-276-0277
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TODD MICHAEL LEVINE
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Credential | DC
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Telephone | 215-276-1100
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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 | DC005968L
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License Number State | PA
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