MEDICARE: HEALTHCARE THERAPY & REHAB CHIROPRACTIC CENTER

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	DC-00006420-L	PA

General Provider Information

NPI Number	:	1326212044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE THERAPY & REHAB CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	1438 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-3936
Country	:	US
Telephone Number	:	215-271-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1438 SNYDER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-3936
Country	:	US
Telephone Number	:	215-271-6000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROGER FARRELL LEVY
Credential	:	D.C.
Telephone Number	:	215-271-6000

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	04/14/2008

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