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Organization

PA PAIN AND REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN CAGAN (VICE PRESIDENT)
(215) 379-2777
Entity
Organization

Contact information

Practice address
6325 WOODLAND AVENUE, PHILADELPHIA, PA 19142
(215) 465-4714
Mailing address
2216 WEST PASSYUNK, PHILADELPHIA, PA 19145
(215) 465-4714

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary

Other

Enumeration date
02/06/2018
Last updated
02/06/2018
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