MEDICARE: DR. KEVIN MICHAEL LOTMAN DC

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	DC002650-L	PA

General Provider Information

NPI Number	:	1235136110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN MICHAEL LOTMAN DC

Provider Business Mailing Address
First Line	:	PO BOX 420
Second Line	:
City	:	BRIER HILL
State	:	PA
Zip	:	15415-0420
Country	:	US
Telephone Number	:	724-785-2270
Fax Number	:	724-785-2270

Provider Business Practice Location Address
First Line	:	6367 NATIONAL PIKE
Second Line	:
City	:	GRINDSTONE
State	:	PA
Zip	:	15442-1114
Country	:	US
Telephone Number	:	724-785-2270
Fax Number	:	724-785-2270

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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