Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC009381 | PA |
NPI | 1215120845 |
---|---|
Provider Name | Alex M Tram |
First Address | Philadelphia, PA 19120-3309 |
Second Address | Philadelphia, PA 19120-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 27/08/2007 |