Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | MC02242 | NJ |
NPI | 1548401524 |
---|---|
Provider Name | Dr. Phillip Alan Levin |
First Address | Voorhees, NJ 08043-3430 |
Second Address | Voorhees, NJ 08043-1858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2009 |
Last Update Date | 20/03/2009 |