Provider Demographics
NPI:1063646073
Name:SYNERGY REHABILITATION AND CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:SYNERGY REHABILITATION AND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GROZALIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-860-9798
Mailing Address - Street 1:105 TERRY DR
Mailing Address - Street 2:STE 114
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1872
Mailing Address - Country:US
Mailing Address - Phone:215-860-9798
Mailing Address - Fax:215-860-3422
Practice Address - Street 1:105 TERRY DR
Practice Address - Street 2:STE 114
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1872
Practice Address - Country:US
Practice Address - Phone:215-860-9798
Practice Address - Fax:215-860-3422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007698L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA054818Medicare PIN