Organization
KK CHIROPRACTIC CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD ELIEZER KANTOR DC (MANAGING DIRECTOR)
(215) 207-1559
Entity
Organization
Contact information
Practice address
11880 BUSTLETON AVE STE 201, PHILADELPHIA, PA 19116-2538
(215) 207-1559
Mailing address
11880 BUSTLETON AVE STE 201, PHILADELPHIA, PA 19116-2538
(215) 207-1559
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-005275-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1131426
ASH
PA
01
—
688402
HIGHMARK BLUE SHIELD
PA
01
—
9599644
AETNA
PA
Enumeration date
11/04/2010
Last updated
12/02/2013
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