Provider Demographics
NPI:1477684157
Name:OAKLANE CHIROPRACTIC AND REHABILITATION
Entity Type:Organization
Organization Name:OAKLANE CHIROPRACTIC AND REHABILITATION
Other - Org Name:DELAWARE VALLEY CHIROPRACTIC & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-924-2225
Mailing Address - Street 1:7165 OGONTZ AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-2015
Mailing Address - Country:US
Mailing Address - Phone:215-924-2225
Mailing Address - Fax:215-924-8098
Practice Address - Street 1:7165 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2015
Practice Address - Country:US
Practice Address - Phone:215-924-2225
Practice Address - Fax:215-924-8098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-003687-L261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service