MEDICARE: ADVANCED CARE CENTERS OF DELAWARE, INC.

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	111NR0400X	Rehabilitation Chiropractor	DC008836	PA

General Provider Information

NPI Number	:	1285762724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARE CENTERS OF DELAWARE, INC.

Provider Business Mailing Address
First Line	:	222 PHILADELPHIA PIKE
Second Line	:	SUITE 2
City	:	WILMINGTON
State	:	DE
Zip	:	19809-3166
Country	:	US
Telephone Number	:	302-472-4878
Fax Number	:	302-472-5504

Provider Business Practice Location Address
First Line	:	222 PHILADELPHIA PIKE
Second Line	:	SUITE 2
City	:	WILMINGTON
State	:	DE
Zip	:	19809-3166
Country	:	US
Telephone Number	:	302-472-4878
Fax Number	:	302-472-5504

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	DR. TIMOTHY A MARTIN
Credential	:	DC
Telephone Number	:	610-361-0070

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	08/22/2020

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