Provider Demographics
NPI:1669664942
Name:THOMAS W GRAZIANO
Entity Type:Organization
Organization Name:THOMAS W GRAZIANO
Other - Org Name:ADVANCED CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-356-2300
Mailing Address - Street 1:580 REED RD
Mailing Address - Street 2:STE 8S
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3655
Mailing Address - Country:US
Mailing Address - Phone:610-356-2300
Mailing Address - Fax:
Practice Address - Street 1:580 REED RD
Practice Address - Street 2:STE 8S
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3655
Practice Address - Country:US
Practice Address - Phone:610-356-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005416L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty