Provider Demographics
NPI:1548214737
Name:GREATER PHILADELPHIA CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:GREATER PHILADELPHIA CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-338-8555
Mailing Address - Street 1:2612 RHAWN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2612 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3415
Practice Address - Country:US
Practice Address - Phone:215-338-8555
Practice Address - Fax:215-338-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005865-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty