Provider Demographics
NPI:1861512147
Name:ELKINS PARK FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:ELKINS PARK FAMILY CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-828-3943
Mailing Address - Street 1:933 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-5503
Mailing Address - Country:US
Mailing Address - Phone:610-272-3330
Mailing Address - Fax:610-272-7113
Practice Address - Street 1:699 W GERMANTOWN PIKE STE 400
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1008
Practice Address - Country:US
Practice Address - Phone:610-828-3943
Practice Address - Fax:610-828-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006090L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1932167905OtherPERSONAL NPI
PA2040164000OtherKEYSTONE PC GROUP
PA2040164000OtherKEYSTONE PC GROUP