Organization
NEW IMAGE & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES GRIM D.C. (CHIROPRACTOR)
(610) 513-8439
Entity
Organization
Contact information
Practice address
2401 PENNSYLVANIA AVE, SUITE 1 A2, PHILADELPHIA, PA 19130-3010
(215) 792-3197
Mailing address
1924 PARKER AVE, HOLMES, PA 19043-1442
(610) 513-8439
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC002444L
PA
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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