Provider Demographics
NPI:1770237679
Name:ADVANCE CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:ADVANCE CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALASDAIR
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-727-4160
Mailing Address - Street 1:PO BOX 716
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-0716
Mailing Address - Country:US
Mailing Address - Phone:215-727-4160
Mailing Address - Fax:215-727-4162
Practice Address - Street 1:6529 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1918
Practice Address - Country:US
Practice Address - Phone:215-727-4160
Practice Address - Fax:215-727-4162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty