MEDICARE: DR. KATIE SUPIK RESICK 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	3216	SC
2	111N00000X	Chiropractor	DC009729	PA
3	111N00000X	Chiropractor	CH9523	FL

General Provider Information

NPI Number	:	1962525451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATIE SUPIK RESICK D.C.

Provider Business Mailing Address
First Line	:	2876 MEADOW ST
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1818
Country	:	US
Telephone Number	:	724-448-2281
Fax Number	:	724-230-0259

Provider Business Practice Location Address
First Line	:	909 DALLAS AVE
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2124
Country	:	US
Telephone Number	:	724-448-2281
Fax Number	:	724-230-0259

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	02/25/2011

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