MEDICARE: DEAN NICHOLSON 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	7833L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841298940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEAN NICHOLSON DC

Provider Business Mailing Address
First Line	:	4411 STILLEY RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-1368
Country	:	US
Telephone Number	:	412-440-0490
Fax Number	:	412-440-0493

Provider Business Practice Location Address
First Line	:	4411 STILLEY RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-1368
Country	:	US
Telephone Number	:	412-440-0490
Fax Number	:	412-440-0493

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	04/01/2011

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Directions to “ DEAN NICHOLSON DC” Practice Location

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