# PA PAIN AND REHAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881193860
- **Authorized official:** JONATHAN CAGAN (VICE PRESIDENT)
- **Authorized official phone:** (215) 379-2777

## Contact information

- **Practice address:** 6325 WOODLAND AVENUE, PHILADELPHIA, PA 19142
- **Practice address phone:** (215) 465-4714
- **Mailing address:** 2216 WEST PASSYUNK, PHILADELPHIA, PA 19145
- **Mailing address phone:** (215) 465-4714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2018
- **Last updated:** 02/06/2018