Organization
VANSANT MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIKA VANSANT D.O. (PRESIDENT)
(215) 551-0200
Entity
Organization
Contact information
Practice address
901 E PASSYUNK AVE, PHILADELPHIA, PA 19147-2924
(215) 551-0200
(215) 551-0209
Mailing address
901 E PASSYUNK AVE, PHILADELPHIA, PA 19147-2924
(215) 551-0200
(215) 551-0209
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC006091L
PA
207QA0505X
Adult Medicine Physician
Primary
OS010207L
PA
261QP2300X
Primary Care Clinic/Center
OS010207L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18130700001
—
PA
Enumeration date
07/24/2013
Last updated
07/24/2013
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