Provider Demographics
NPI:1376668616
Name:GELEZINSKY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:GELEZINSKY CHIROPRACTIC INC.
Other - Org Name:COVENTRY CHIROPRACTIC REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GELEZINSKY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:215-256-9466
Mailing Address - Street 1:220 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964-1609
Mailing Address - Country:US
Mailing Address - Phone:215-723-9166
Mailing Address - Fax:215-723-9197
Practice Address - Street 1:220 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-1609
Practice Address - Country:US
Practice Address - Phone:215-723-9166
Practice Address - Fax:215-723-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006746L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty