MEDICARE: ALLEGHENY FAMILY 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	111N00000X	Chiropractor	DC002404L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790898336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHENY FAMILY CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	2514 E ALLEGHENY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-5102
Country	:	US
Telephone Number	:	215-425-1110
Fax Number	:	215-425-5610

Provider Business Practice Location Address
First Line	:	2514 E ALLEGHENY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-5102
Country	:	US
Telephone Number	:	215-425-1110
Fax Number	:	215-425-5610

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	MR. RAYMOND J KENT
Credential	:	DC
Telephone Number	:	215-425-1110

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	08/22/2020

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