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NPI Code Detail

MEDICARE: SPRUCE CHIROPRACTIC HEALTH CENTER, P.C.

MEDICARE: SPRUCE CHIROPRACTIC HEALTH 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1134319189
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRUCE CHIROPRACTIC HEALTH CENTER, P.C.
Provider Business Mailing Address
First Line : 1421 SPRUCE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-4533
Country : US
Telephone Number : 215-735-2997
Fax Number : 215-735-5222
Provider Business Practice Location Address
First Line : 1421 SPRUCE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-4533
Country : US
Telephone Number : 215-735-2997
Fax Number : 215-735-5222
Authorized Official
Title or Position : PRESIDENT
Name : DR. ANDREW CHARLES INDRISO
Credential : D.C.
Telephone Number : 215-735-2997
Provider Enumeration Date : 07/26/2007
Last Update Date : 07/26/2007

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Directions to “SPRUCE CHIROPRACTIC HEALTH CENTER, P.C. ” Practice Location

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