MEDICARE: DR. JESSICA BERELSMAN 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-05191	OH

General Provider Information

NPI Number	:	1467173070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA BERELSMAN DC

Provider Business Mailing Address
First Line	:	422 N COLUMBUS ST
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-3033
Country	:	US
Telephone Number	:	740-422-8484
Fax Number	:

Provider Business Practice Location Address
First Line	:	422 N COLUMBUS ST
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-3033
Country	:	US
Telephone Number	:	740-422-8484
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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