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Organization

ROBERTS FAMILY & SPORTS CHIROPRACTIC

Active
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Organization

ROBERTS FAMILY & SPORTS CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEONARD J ROBERTS DC (OWNER)
(215) 487-2500
Entity
Organization

Contact information

Practice address
8151 RIDGE AVE, PHILADELPHIA, PA 19128-2902
(215) 487-2500
(215) 487-7463
Mailing address
8151 RIDGE AVE, PHILADELPHIA, PA 19128-2902
(215) 487-2500
(215) 487-7463

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC008037L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0856152000
IBC
PA
01
163629449
AMERIHEALTH ADMINISTRATOR
DE
01
163629449
AMERIHEALTH ADMINISTRATOR
NJ
01
2671626
AENTA NON HMO
PA
01
906443
HIGHMARK BLUE SHIELD
PA
Enumeration date
06/21/2006
Last updated
06/25/2010
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