MEDICARE: KS CHIROPRACTIC, PC

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	DC009729	PA

General Provider Information

NPI Number	:	1063716744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KS CHIROPRACTIC, PC

Provider Business Mailing Address
First Line	:	2876 MEADOW ST
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1818
Country	:	US
Telephone Number	:	724-448-2281
Fax Number	:	724-230-0259

Provider Business Practice Location Address
First Line	:	909 DALLAS AVE
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2124
Country	:	US
Telephone Number	:	724-230-0255
Fax Number	:	724-230-0259

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KATIE SUPIK RESICK
Credential	:	DC
Telephone Number	:	724-448-2281

Provider Enumeration Date	:	01/10/2011
Last Update Date	:	01/10/2011

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Directions to “KS CHIROPRACTIC, PC ” Practice Location

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