Provider Demographics
NPI:1104016625
Name:SELL CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:SELL CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-942-2626
Mailing Address - Street 1:229 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6448
Mailing Address - Country:US
Mailing Address - Phone:215-942-2626
Mailing Address - Fax:215-942-2628
Practice Address - Street 1:229 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6448
Practice Address - Country:US
Practice Address - Phone:215-942-2626
Practice Address - Fax:215-942-2628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2815342000OtherIBC GROUP ID
PA2633238000OtherIBC INDIVIDUAL ID
PA097236Medicare PIN
PA2815342000OtherIBC GROUP ID