TRI-STATE SPORT AND SPINE PLLC NPI 1578921359

NPI Information

TRI-STATE SPORT AND SPINE, PLLC is a chiropractor in Philadelphia, PA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. TRI-STATE SPORT AND SPINE, PLLC NPI is 1578921359. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 SOUTH BROAD STREET
1800
PHILADELPHIA, PA
ZIP 19110
Phone: (215) 988-9503
Fax: (215) 988-9533

The provider's authorized official is Michael Dougherty .
The authorized official title is Owner and has the following contact phone number (609) 760-0386.

The enumeration date for this NPI number is 2/8/2016 and was last updated on 2/8/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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