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NPI Code Detail

MEDICARE: JOHN R DIMOND DC

MEDICARE: JOHN R DIMOND 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
1111N00000XChiropractorDC001391LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093891350
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN R DIMOND DC
Provider Business Mailing Address
First Line : OLD RTE 66 & HILL STREET
Second Line : BOX 200
City : MCGRANN
State : PA
Zip : 16236
Country : US
Telephone Number : 724-763-8000
Fax Number :
Provider Business Practice Location Address
First Line : OLD RTE 66 & HILL STREET
Second Line : # 200
City : MCGRANN
State : PA
Zip : 16236
Country : US
Telephone Number : 724-763-8000
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOHN R DIMOND
Credential : DC
Telephone Number : 724-763-8000
Provider Enumeration Date : 10/30/2006
Last Update Date : 01/09/2008

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