MEDICARE: DR. JAMES EDWARD MOYLAN 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	004382L	PA

General Provider Information

NPI Number	:	1326009085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES EDWARD MOYLAN D.C.

Provider Business Mailing Address
First Line	:	PO BOX 37503
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-7503
Country	:	US
Telephone Number	:	267-324-3461
Fax Number	:	267-324-3464

Provider Business Practice Location Address
First Line	:	1301 S 3RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-6008
Country	:	US
Telephone Number	:	267-324-3461
Fax Number	:	267-324-3464

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	05/16/2014

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