Provider Demographics
NPI:1467677542
Name:TELLER CHIROPRACTIC
Entity Type:Organization
Organization Name:TELLER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-569-1900
Mailing Address - Street 1:2026 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4446
Mailing Address - Country:US
Mailing Address - Phone:215-569-1900
Mailing Address - Fax:215-569-2776
Practice Address - Street 1:2026 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4446
Practice Address - Country:US
Practice Address - Phone:215-569-1900
Practice Address - Fax:215-569-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty