| NPI | 1588955678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARRAD TELLER Owner 610-352-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD035566E) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC-007527-L) |
| 111N00000X Chiropractor (Licence: PA DC10647) | |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2025-06-16 |