MEDICARE: COTTMAN CHIROPRACTIC CENTER P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC002400L	PA

General Provider Information

NPI Number	:	1023064425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COTTMAN CHIROPRACTIC CENTER P.C.

Provider Business Mailing Address
First Line	:	3002 HOLME AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-1907
Country	:	US
Telephone Number	:	215-708-0657
Fax Number	:	215-708-0659

Provider Business Practice Location Address
First Line	:	3002 HOLME AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-1907
Country	:	US
Telephone Number	:	215-708-0657
Fax Number	:	215-708-0659

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM B KARABINOS
Credential	:	D.C.
Telephone Number	:	215-708-0657

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	03/10/2010

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