Organization
RED LION CHIROPRACTIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARISA GRANOVSKY DC (PRESIDENT)
(215) 464-0404
Entity
Organization
Contact information
Practice address
842 RED LION RD, #8, PHILADELPHIA, PA 19115-1475
(215) 464-0404
(215) 464-0683
Mailing address
842 RED LION RD, #8, PHILADELPHIA, PA 19115-1475
(215) 464-0404
(215) 464-0683
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006295L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015288270001
—
PA
Enumeration date
02/20/2013
Last updated
02/20/2013
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