Millennium Chiropractic Center PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC006309L Issued in PA

Legal business name

MILLENNIUM CHIROPRACTIC CENTER PC

Practice address

1619 Grant Ave
Grant Plaza II
Phila, PA 19115

Phone

(215) 934-5401

Fax

(215) 934-5452

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Fern M Grossman, DC

Title

Pres

Phone

(215) 934-5401

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1356480404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 GRANT AVE",
            "address_2": "GRANT PLAZA II",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-934-5401",
            "fax_number": "215-934-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 GRANT AVE",
            "address_2": "GRANT PLAZA II",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-934-5401",
            "fax_number": "215-934-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "FERN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "215-934-5401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006309L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2053318000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "MI1361038",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Charles Metroka, D.D.S.
• Katouchca Michel, FNP
• Pasquale Mignano, DO
• Keshia Lynette Miles, LPN
• Jennifer Marie Millado, PA-C
• Lauren L Miller-Ford
• Crystal Miller, MS, BCBA, LBS
• Seth Lee Miller, D.D.S.
• Yurika Miller, M.A.
• Mindful Minds Health & Wellness

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.