Provider Demographics
NPI:1235675992
Name:ISFM LIMITED
Entity Type:Organization
Organization Name:ISFM LIMITED
Other - Org Name:IDEAL SPINE AND FUNCTIONAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOKE
Authorized Official - Middle Name:T
Authorized Official - Last Name:TAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:267-687-7875
Mailing Address - Street 1:525 S 4TH ST STE 254
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1573
Mailing Address - Country:US
Mailing Address - Phone:267-687-7875
Mailing Address - Fax:
Practice Address - Street 1:525 S 4TH ST STE 254
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1573
Practice Address - Country:US
Practice Address - Phone:267-687-7875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009450111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty