Organization
VITASOURCE CHIROPRACTIC & REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEAN HAROLD FONTAINE D.C. (DOCTOR OF CHIROPRACTIC)
(215) 276-2250
Entity
Organization
Contact information
Practice address
1831 W CHELTENHAM AVE, ELKINS PARK, PA 19027-1049
(215) 276-2250
(215) 276-2110
Mailing address
1831 W CHELTENHAM AVE, ELKINS PARK, PA 19027-1049
(215) 276-2250
(215) 276-2110
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
DC010306
PA
Other
Enumeration date
07/05/2013
Last updated
07/05/2013
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