MEDICARE: DIMOND CHIROPRACTIC

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	DC009633	PA

General Provider Information

NPI Number	:	1922526409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIMOND CHIROPRACTIC

Provider Business Mailing Address
First Line	:	PO BOX 200
Second Line	:	570 HILL ST
City	:	MCGRANN
State	:	PA
Zip	:	16236
Country	:	US
Telephone Number	:	724-763-8000
Fax Number	:	724-763-8007

Provider Business Practice Location Address
First Line	:	570 HILL ST
Second Line	:
City	:	MCGRANN
State	:	PA
Zip	:	16236
Country	:	US
Telephone Number	:	724-763-8000
Fax Number	:	724-763-8007

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	NANCY I WASSON
Credential	:
Telephone Number	:	724-763-8000

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	05/07/2018

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Directions to “DIMOND CHIROPRACTIC ” Practice Location

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