MEDICARE: DR. JACQUELINE TRAMONTIN 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	111N00000X	Chiropractor	DC005188L	PA

General Provider Information

NPI Number	:	1750379483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE TRAMONTIN D.C.

Provider Business Mailing Address
First Line	:	173 E MAIN ST
Second Line	:
City	:	MACUNGIE
State	:	PA
Zip	:	18062-1310
Country	:	US
Telephone Number	:	610-966-2726
Fax Number	:	484-214-0195

Provider Business Practice Location Address
First Line	:	173 E MAIN ST
Second Line	:
City	:	MACUNGIE
State	:	PA
Zip	:	18062-1310
Country	:	US
Telephone Number	:	610-966-2726
Fax Number	:	484-214-0195

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	02/10/2014

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