MEDICARE: DR. CHARLES THOMAS STATTI D.C.

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	111NX0800X	Orthopedic Chiropractor	DC1583L	PA

General Provider Information

NPI Number	:	1518928852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES THOMAS STATTI D.C.

Provider Business Mailing Address
First Line	:	890 BEAVER GRADE RD
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2653
Country	:	US
Telephone Number	:	412-262-1232
Fax Number	:	412-262-6191

Provider Business Practice Location Address
First Line	:	890 BEAVER GRADE RD
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2653
Country	:	US
Telephone Number	:	412-262-1232
Fax Number	:	412-262-6191

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	07/08/2007

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