Provider Demographics
NPI:1760647804
Name:WEST PHILADELPHIA REHAB AND MEDICAL
Entity Type:Organization
Organization Name:WEST PHILADELPHIA REHAB AND MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE REPRESENTATIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TONER PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-524-6480
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-0056
Mailing Address - Country:US
Mailing Address - Phone:610-524-6480
Mailing Address - Fax:610-524-0653
Practice Address - Street 1:2701 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-2743
Practice Address - Country:US
Practice Address - Phone:215-223-2356
Practice Address - Fax:215-223-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty