MEDICARE: WEST PHILADELPHIA REHAB AND MEDICAL

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

General Provider Information

NPI Number	:	1760647804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PHILADELPHIA REHAB AND MEDICAL

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	EXTON
State	:	PA
Zip	:	19341-0056
Country	:	US
Telephone Number	:	610-524-6480
Fax Number	:	610-524-0653

Provider Business Practice Location Address
First Line	:	2701 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-2743
Country	:	US
Telephone Number	:	215-223-2356
Fax Number	:	215-223-2358

Authorized Official
Title or Position	:	OFFICE REPRESENTATIVE
Name	:	MS. KARIN M TONER PIERCE
Credential	:
Telephone Number	:	610-524-6480

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	07/28/2008

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Directions to “WEST PHILADELPHIA REHAB AND MEDICAL ” Practice Location

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