MEDICARE: STEVEN ANTHONY HAAS 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	390200000X	Student in an Organized Health Care Education/Training Program
2	111N00000X	Chiropractor	DC010220	PA

General Provider Information

NPI Number	:	1184828212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN ANTHONY HAAS D.C.

Provider Business Mailing Address
First Line	:	4519 TUDOR ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-4013
Country	:	US
Telephone Number	:	267-231-5032
Fax Number	:

Provider Business Practice Location Address
First Line	:	4519 TUDOR ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-4013
Country	:	US
Telephone Number	:	215-908-1996
Fax Number	:

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

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	03/05/2012

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