MEDICARE: PRO ADJUSTER REHABILITATION

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	DC007537L	PA

General Provider Information

NPI Number	:	1437195930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO ADJUSTER REHABILITATION

Provider Business Mailing Address
First Line	:	523 RAVINE ST
Second Line	:	SUITE 220
City	:	DRAVOSBURG
State	:	PA
Zip	:	15034-1012
Country	:	US
Telephone Number	:	412-466-9100
Fax Number	:	412-466-9485

Provider Business Practice Location Address
First Line	:	523 RAVINE ST
Second Line	:	SUITE 220
City	:	DRAVOSBURG
State	:	PA
Zip	:	15034-1012
Country	:	US
Telephone Number	:	412-466-9100
Fax Number	:	412-466-9485

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JOHN PAUL SWADE
Credential	:	D.C.
Telephone Number	:	412-466-9100

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	01/14/2008

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