Provider Demographics
NPI:1649385337
Name:RHINO CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:RHINO CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CIASULLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-844-4400
Mailing Address - Street 1:6809 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2112
Mailing Address - Country:US
Mailing Address - Phone:215-844-4400
Mailing Address - Fax:215-844-4070
Practice Address - Street 1:6809 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2112
Practice Address - Country:US
Practice Address - Phone:215-844-4400
Practice Address - Fax:215-844-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA095096Medicare UPIN