Provider Demographics
NPI:1043360415
Name:MABIE, TABITHA KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:KAY
Last Name:MABIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OLD YORK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3912
Mailing Address - Country:US
Mailing Address - Phone:215-887-5400
Mailing Address - Fax:
Practice Address - Street 1:101 OLD YORK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3912
Practice Address - Country:US
Practice Address - Phone:215-887-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor