Provider Demographics
NPI:1043650773
Name:REHAB 2 WELLNESS CHIROPRACTIC PC
Entity type:Organization
Organization Name:REHAB 2 WELLNESS CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSCIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-853-9000
Mailing Address - Street 1:510 DARBY RD STE 3A
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4630
Mailing Address - Country:US
Mailing Address - Phone:610-853-9000
Mailing Address - Fax:
Practice Address - Street 1:510 DARBY RD STE 3A
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4630
Practice Address - Country:US
Practice Address - Phone:610-853-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010721111N00000X
PAAJ010514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty