Individual
FERN MARLA GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1619 GRANT AVE, GRANT PLAZA II, PHILADELPHIA, PA 19115-3167
(215) 934-5401
(215) 934-5452
Mailing address
1619 GRANT AVE, GRANT PLAZA II, PHILADELPHIA, PA 19115-3167
(215) 934-5401
(215) 934-5452
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006309L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2053318000
IBX
PA
Enumeration date
11/28/2006
Last updated
07/08/2007
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