Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC-6420-L | PA |
NPI | 1326171646 |
---|---|
Provider Name | Dr. Roger Farrell Levy |
First Address | Philadelphia, PA 19145-3936 |
Second Address | Philadelphia, PA 19145-3936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |