MEDICARE: JOSEPH A ORTENZIO JR. 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	261Q00000X	Clinic/Center

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	:	1861642639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH A ORTENZIO JR. D.C.

Provider Business Mailing Address
First Line	:	40 PARK DR
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-1850
Country	:	US
Telephone Number	:	330-426-9453
Fax Number	:	330-426-6815

Provider Business Practice Location Address
First Line	:	40 PARK DR
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-1850
Country	:	US
Telephone Number	:	330-426-9453
Fax Number	:	330-426-6815

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH ANTHONY ORTENZIO JR.
Credential	:	D.C.
Telephone Number	:	330-426-9453

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	01/30/2009

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