MEDICARE: DR. ETHEL CHRISTINA HARVEY D.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	DC006838-L	PA

General Provider Information

NPI Number	:	1043339195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ETHEL CHRISTINA HARVEY D.C.

Provider Business Mailing Address
First Line	:	5760 KEMBLE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-1209
Country	:	US
Telephone Number	:	215-275-3797
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 W OLNEY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2220
Country	:	US
Telephone Number	:	215-275-3797
Fax Number	:	215-549-7371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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