Individual
KEVIN MICHAEL OMELIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2026 CHESTNUT ST, PHILADELPHIA, PA 19103
(215) 569-1900
(215) 569-2776
Mailing address
2026 CHESTNUT ST, PHILADELPHIA, PA 19103
(215) 569-1900
(215) 569-2776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC8637
PA
133N00000X
Nutritionist
DN003994
PA
133V00000X
Registered Dietitian
DN003994
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1180341
HORIZON BLUE CROSS BLUE SHIELD OF NJ
NJ
01
—
11913763
CAQH ID
—
01
—
2622003
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/31/2006
Last updated
06/10/2013
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