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NPI Code Detail

MEDICARE: BLUE SKIES CHIROPRACTIC, PC

MEDICARE: BLUE SKIES CHIROPRACTIC, PC
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
1111N00000XChiropractorDC007899LPA

General Provider Information

NPI Number : 1043637622
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE SKIES CHIROPRACTIC, PC
Provider Business Mailing Address
First Line : 3502 SCOTTS LANE
Second Line : A-13
City : PHILADELPHIA
State : PA
Zip : 19129
Country : US
Telephone Number : 211-844-8484
Fax Number : 215-933-5232
Provider Business Practice Location Address
First Line : 3502 SCOTTS LN
Second Line : A-13
City : PHILADELPHIA
State : PA
Zip : 19129-1561
Country : US
Telephone Number : 211-844-8484
Fax Number : 215-933-5232
Authorized Official
Title or Position : CHIROPRACTOR/OWNER
Name : DR. RONALD T. MERRIEL JR.
Credential : DC
Telephone Number : 215-844-8484
Provider Enumeration Date : 03/21/2014
Last Update Date : 03/21/2014

Similar Medicare Providers

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Directions to “BLUE SKIES CHIROPRACTIC, PC ” Practice Location

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