Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tri-State Sport and Spine, PLLC

Organization Chiropractor · NPI 1902200876

Tri-State Sport and Spine, PLLC provides Chiropractor services in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9331 Old Bustleton Ave Ste 101
Philadelphia, PA 19115-4204 Not confirmed with CMS for 11 years — call before visiting
Phone: (215) 251-8526
Fax: (215) 673-1980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence DC010688 (PA)

Record details

NPI number1902200876
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Dougherty — President · (215) 251-8526
NPI enumeratedOctober 21, 2014
Last updated in NPPESOctober 21, 2014
Mailing address110 Wharton St, Philadelphia, PA 19147-5425

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