Organization
CHIROPRACTIC SPINE CENTER IV
Active
Organization
CHIROPRACTIC SPINE CENTER IV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE GLAZER D.C. (PRESIDENT)
(610) 254-8200
Entity
Organization
Contact information
Practice address
744 W LANCASTER AVE, SUITE 105, WAYNE, PA 19087-2523
(610) 254-8200
(610) 254-8263
Mailing address
744 W LANCASTER AVE, SUITE 105, WAYNE, PA 19087-2523
(610) 254-8200
(610) 254-8263
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC007347L
PA
225100000X
Physical Therapist
AJ-007347-L
PA
Other
Enumeration date
05/28/2006
Last updated
06/14/2016
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