MEDICARE: RUBINA TAHIR CHIROPRACTIC, LLC

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	010904	PA

General Provider Information

NPI Number	:	1568860427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBINA TAHIR CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	870 N 28TH ST
Second Line	:	120
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1732
Country	:	US
Telephone Number	:	267-340-5014
Fax Number	:

Provider Business Practice Location Address
First Line	:	7592 HAVERFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-2113
Country	:	US
Telephone Number	:	215-879-4499
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. RUBINA TAHIR
Credential	:	DC
Telephone Number	:	267-340-5014

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	12/09/2014

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