Organization
TROLLEY SQUARE PAIN RELIEF CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FULLER DC (OWNER)
(302) 421-3660
Entity
Organization
Contact information
Practice address
1523 DELAWARE AVE, WILMINGTON, DE 19806-3005
(302) 421-3660
(302) 421-3662
Mailing address
1523 DELAWARE AVE, WILMINGTON, DE 19806-3005
(302) 421-3660
(302) 421-3662
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC008807
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629135942
INDIVIDUAL NPI
PA
Enumeration date
12/21/2007
Last updated
12/21/2007
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