Provider Demographics
NPI:1003660028
Name:SCW MEDICAL II LLC
Entity Type:Organization
Organization Name:SCW MEDICAL II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-763-5251
Mailing Address - Street 1:1509 DURWOOD CT
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1016
Mailing Address - Country:US
Mailing Address - Phone:610-763-5251
Mailing Address - Fax:
Practice Address - Street 1:3646 POTTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-1700
Practice Address - Country:US
Practice Address - Phone:610-678-8600
Practice Address - Fax:610-678-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty