MEDICARE: DR. ANNETTE MARICE CLEMENTE 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	DC-006834-L	PA

General Provider Information

NPI Number	:	1417944679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNETTE MARICE CLEMENTE DC

Provider Business Mailing Address
First Line	:	1971 W CHESTNUT ST
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-2639
Country	:	US
Telephone Number	:	724-222-5232
Fax Number	:	724-225-5141

Provider Business Practice Location Address
First Line	:	1971 W CHESTNUT ST
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-2639
Country	:	US
Telephone Number	:	724-222-5232
Fax Number	:	724-225-5141

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	07/20/2010

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