Provider Demographics
NPI:1619121936
Name:TABOR CHIROPRACTIC &REHABILITATION LLC
Entity Type:Organization
Organization Name:TABOR CHIROPRACTIC &REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR.
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARTASIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-549-5810
Mailing Address - Street 1:3 HOVTECH BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6306
Mailing Address - Country:US
Mailing Address - Phone:856-235-0202
Mailing Address - Fax:856-235-3377
Practice Address - Street 1:1335 W TABOR RD
Practice Address - Street 2:SUITE 306
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3038
Practice Address - Country:US
Practice Address - Phone:215-549-5810
Practice Address - Fax:215-549-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007418L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty