Tedd Koren, D.C.
Individual provider Active NPI Chiropractor · Gwynedd Valley, PA
NPI 1306258389 · NPPES record last updated May 27, 2014
Key facts
- NPI
- 1306258389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1672 (PA)
- Practice address
- 301 Wood Spring Road
Gwynedd Valley, PA 19437-0665 - Phone
- (215) 699-7906
- NPI assigned
- May 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1672 | PA | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1672 | PA | Yes |
Addresses
Primary practice location
301 Wood Spring Road
Gwynedd Valley, PA 19437-0665
Mailing address
PO Box 665
301 Wood Spring Road
Gwynedd Valley, PA 19437-0665
Phone (215) 699-7906
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 156EAST57 | Other | PRIVATE PRACTISE |
Other providers in Gwynedd Valley, PA
- Jay K. Cherney
- Patricia A Edinger
- Gwynedd Mercy Academy High School
- Mercedes Angelique Himmons
- Kristyn Holmes
- Patrick Thomas Martin
- Melissa Anne Mascio-Primus
- Allen Oliff
- Dominique Noel Pacitti
- Robert Segal
All providers in Gwynedd Valley, PA · Chiropractor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.