Philadelphia Spine and Wellness CNTR.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC005975-L Issued in PA

Legal business name

PHILADELPHIA SPINE AND WELLNESS CNTR.

Practice address

100 South Broad Street
Suite 1800 B
Philadelphia, PA 19110

Phone

(215) 988-9503

Fax

(215) 988-9533

NPI assigned

Jun 3, 2009

Last updated

Jun 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Joseph Polino, DC

Title

Ceo/Chiropractor

Phone

(215) 988-9503

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1073749123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH BROAD STREET",
            "address_2": "SUITE 1800 B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19110",
            "telephone_number": "215-988-9503",
            "fax_number": "215-988-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH BROAD STREET",
            "address_2": "SUITE 1800 B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19110",
            "telephone_number": "215-988-9503",
            "fax_number": "215-988-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA SPINE AND WELLNESS CNTR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "POLINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO/CHIROPRACTOR",
        "authorized_official_telephone_number": "215-988-9503",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC005975-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philadelphia School of Psychoanalysis
• Philadelphia School of Psychoanalysis
• Philadelphia Senior Care LLC (Griswold Home Care for Philadelphia Center City)
• Philadelphia Sleep Center Inc. (Philadelphia Sleep Center -Home Services)
• Philadelphia Smile Ceter LLC
• Philadelphia Spine Associates
• Philadelphia Supportive Living Solutions
• Philadelphia Supportive Living Solutions LLC
• Philadelphia Surgi Center, Inc.
• Philadelphia Surgical, LLC

• Chiropractor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.