Healthcare Provider Details

I. General information

NPI: 1306933122
Provider Name (Legal Business Name): PAULA ESTELLE DIMAIO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 MACDADE BLVD # A
MILMONT PARK PA
19033-3624
US

IV. Provider business mailing address

1004 MACDADE BLVD # A
MILMONT PARK PA
19033-3624
US

V. Phone/Fax

Practice location:
  • Phone: 610-534-2273
  • Fax: 610-534-4629
Mailing address:
  • Phone: 610-534-2273
  • Fax: 610-534-4629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberD.C. 004582 - L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: