TRI-STATE SPORT AND SPINE, PLLC


Address: 100 South Broad Street, 1800, Philadelphia, PA 19110
Phone: 2159889503

TRI-STATE SPORT AND SPINE, PLLC (NPI# 1578921359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578921359
Entity Type Organization
Organization Name TRI-STATE SPORT AND SPINE, PLLC
Practice Address 100 South Broad Street
1800
Philadelphia
PA 19110
Mailing Address 110 Wharton St
Philadelphia
PA 19147-5425
Practice Telephone 2159889503
Practice Fax Number 2159889533
Mailing Telephone 6097600386
Enumeration Date 2016-02-08
Last Update Date 2016-02-08
Authorized Official Name MICHAEL DOUGHERTY (OWNER)
Authorized Official Telephone 6097600386
Authorized Official Credential DC
Is Organization Subpart Y
Parent Organization Name TRI-STATE SPORT AND SPINE, PLLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 111N00000X Chiropractor DC010688 PA Chiropractic Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1902200876 Tri-state Sport and Spine, Pllc Chiropractor 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4204 2014-10-21

Office Location

Street Address 100 SOUTH BROAD STREET
1800
City PHILADELPHIA
State PA
Zip Code 19110

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023177144 Joseph J. Peters Institute Community/Behavioral Health 100 South Broad Street, 17th Floor, Philadelphia, PA 19110 2006-12-06
1104481316 Alyssa Levy-dougherty Social Worker 100 South Broad Street, 17th Floor, Philadelphia, PA 19110-9997 2019-05-02
1073749123 Philadelphia Spine and Wellness Cntr. Chiropractor 100 South Broad Street, Suite 1800 B, Philadelphia, PA 19110 2009-06-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518332543 Thomas Fredrick Haworth Psychologist 100 South Broad St, Suite 1700, Philadelphia, PA 19110 2015-12-02
1588076178 Hanel Ariel Choi Dentist 100 S. Broad St. Suite 1530, Philadelphia, PA 19110 2014-05-29
1104093004 Erin Hadley Psychologist 100 S. Broad St., Suite 915, Philadelphia, PA 19110 2008-05-11
1407053846 Kimberly Davis Chiropractor 100 S Broad Street, Suite 1800b, Philadelphia, PA 19110 2007-06-29
1366997223 Jenna Courtney Rosenau Social Worker 100 S Broad Street, Suite 1920, Philadelphia, PA 19110 2016-08-22
1164802708 Jordan Levy Social Worker 100 S. Broad Street, Suite 1515, Philadelphia, PA 19110 2015-06-08
1528485828 Boston Medical Group Pennsylvania, P.C. Urology 100 S. Broad Street, Suite 2136, Philadelphia, PA 19110 2014-03-25
1821434788 Kathleen Fragale Physical Therapist 100 S Broad Street, Suite 1800b, Philadelphia, PA 19110 2013-05-20
1871864223 Andrew Rittenhouse Chiropractor 100 S Broad Street, Suite 1800b, Philadelphia, PA 19110 2012-01-17
1255757373 Elizabeth Earnshaw Counselor 100 S Broad St Ste 1304, Philadelphia, PA 19110-1004 2014-03-13
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Taxonomy Information

Taxonomy Code 111N00000X
Grouping Chiropractic Providers
Classification Chiropractor

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1124628540 Citywide North, PC Chiropractor 2304-a North Broad Street, Philadelphia, PA 19132-4563 2020-10-26
1598313488 Dev Avinash Rajhansa Chiropractor 101 W Allens Ln, Philadelphia, PA 19119-4101 2019-09-03
1861059859 Joshua James Kramarenko Chiropractor 1608 Walnut St Ste 601, Philadelphia, PA 19103-5447 2019-05-24
1306409024 Danielle Louise Walsh Chiropractor 3500 Scotts Ln Ste 215, Philadelphia, PA 19129-1836 2019-04-18
1952868804 Yoon Sang Song Chiropractor 6115 Woodland Ave, Philadelphia, PA 19142-2418 2019-02-27
1104381011 Anthony James Havens Jr. Chiropractor 6006 Chestnut St Fl 1, Philadelphia, PA 19139-3044 2019-02-05
1750851390 Philadelphia Pain and Neurology Institute, LLC Chiropractor 1528 Walnut Street Suite 620, Philadelphia, PA 19102 2018-11-27
1710467626 Darin Mathew Daniel Chiropractor 2216 W Passyunk Ave, Philadelphia, PA 19145-3318 2018-08-20
1780184952 Chelsea Ann Mclane Chiropractor 430 Green Ln, Philadelphia, PA 19128-3304 2018-02-14
1881193860 Pa Pain and Rehab Chiropractor 6325 Woodland Avenue, Philadelphia, PA 19142 2018-02-06
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Competitor

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City PHILADELPHIA
Zip Code 19110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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