MEDICARE: SPINAL REHAB NETWORK, INC.

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	:	1942513825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINAL REHAB NETWORK, INC.

Provider Business Mailing Address
First Line	:	2813 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1421
Country	:	US
Telephone Number	:	215-767-8218
Fax Number	:	215-332-1436

Provider Business Practice Location Address
First Line	:	2813 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1421
Country	:	US
Telephone Number	:	267-257-6279
Fax Number	:	215-546-1373

Authorized Official
Title or Position	:	VP
Name	:	DR. TODD D COMER
Credential	:	DC
Telephone Number	:	267-257-6279

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	12/02/2024

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