Organization
KEYSTONE PAIN MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARRAD TELLER DC (OWNER)
(610) 351-1710
Entity
Organization
Contact information
Practice address
7016 TERMINAL SQ, SUITE 10A, UPPER DARBY, PA 19082-2337
(610) 352-1710
(610) 352-1740
Mailing address
PO BOX 154, CEDAR BROOK, NJ 08018-0154
(609) 704-1857
(609) 704-1859
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC007527L
PA
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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