Organization
MILLENNIUM CHIROPRACTIC CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERN M GROSSMAN DC (PRES)
(215) 934-5401
Entity
Organization
Contact information
Practice address
1619 GRANT AVE, GRANT PLAZA II, PHILA, PA 19115
(215) 934-5401
(215) 934-5452
Mailing address
1619 GRANT AVE, GRANT PLAZA II, PHILA, PA 19115
(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
IBC
—
01
—
MI1361038
BLUE SHIELD
PA
Enumeration date
02/05/2007
Last updated
08/04/2010
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