Provider Demographics
NPI:1629098371
Name:HARDING, MITCHELL C (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:C
Last Name:HARDING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ARCH ST
Mailing Address - Street 2:UNIT 502
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-2028
Mailing Address - Country:US
Mailing Address - Phone:570-764-0528
Mailing Address - Fax:
Practice Address - Street 1:1425 ARCH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1507
Practice Address - Country:US
Practice Address - Phone:215-557-9090
Practice Address - Fax:215-557-9089
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1476648OtherPA BLUE SHIELD
PA2157340000OtherINDEPENDENCE BLUE CROSS