Organization
COORDINATED HEALTH CENTER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY TICKLE DC (OWNER)
(610) 667-8412
Entity
Organization
Contact information
Practice address
104 FORREST AVE, NARBERTH, PA 19072-2215
(610) 667-8412
(610) 667-8413
Mailing address
104 FORREST AVE, NARBERTH, PA 19072-2215
(610) 667-8412
(610) 667-8413
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006360L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145478000
HIGHMARK BS
PA
Enumeration date
03/13/2008
Last updated
07/07/2009
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