MEDICARE: MISS RITA MADDALENA CASTRIOTTA D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	12277	TX

General Provider Information

NPI Number	:	1164764312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RITA MADDALENA CASTRIOTTA D.C.

Provider Business Mailing Address
First Line	:	205 WILD BASIN RD STE 2B
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-3304
Country	:	US
Telephone Number	:	512-328-0505
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 WILD BASIN RD STE 2B
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-3304
Country	:	US
Telephone Number	:	512-328-0505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2013
Last Update Date	:	03/25/2013

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