Chiropractic Spine Center IV

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

DC007347L Issued in PA

Legal business name

CHIROPRACTIC SPINE CENTER IV

Practice address

744 W Lancaster Ave
Suite 105
Wayne, PA 19087-2523

Phone

(610) 254-8200

Fax

(610) 254-8263

NPI assigned

May 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Theodore Glazer, D.C.NPI 1750344867

Title

President

Phone

(610) 254-8200

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theodore A Glazer, D.C.

  • Chiropractor
  • Wayne, PA
  • NPI 1750344867
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1063469740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W LANCASTER AVE",
            "address_2": "SUITE 105",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872523",
            "telephone_number": "610-254-8200",
            "fax_number": "610-254-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W LANCASTER AVE",
            "address_2": "SUITE 105",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872523",
            "telephone_number": "610-254-8200",
            "fax_number": "610-254-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC SPINE CENTER IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "GLAZER",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-254-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC007347L",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "AJ-007347-L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Chadwick
• Mineela Jayapriya Chand, B.SC., M.DIV., LMFT
• Karima Chen, FNP
• Yijiun Chen, LPC, NCC
• Stefanie Anne Cherup, MSS, MLSP, LSW
• Asare B Christian
• Hyee W Chung, LCSW
• Kelly Brynn Cicippio, M.A.
• Brian Patrick Cleary, PT
• William Albert Cleveland, D.M.D.

• Rehabilitation Chiropractor in Wayne, PA
• Providers in Wayne, PA by specialty
• Rehabilitation Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.