MEDICARE: RUSSAMANO CHIROPRACTIC CENTER, PC

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	DC008686	PA

General Provider Information

NPI Number	:	1528003340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSSAMANO CHIROPRACTIC CENTER, PC

Provider Business Mailing Address
First Line	:	3330 NAZARETH RD
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-2018
Country	:	US
Telephone Number	:	610-252-3449
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 NAZARETH RD
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-2018
Country	:	US
Telephone Number	:	610-252-3449
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL J RUSSAMANO
Credential	:	D.C.
Telephone Number	:	434-817-7788

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/22/2020

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