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Individual

ANTHONY DEPIETRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1536 MAIN ST, 1ST FLOOR REAR, PECKVILLE, PA 18452-2062
(570) 291-4450
(570) 291-4454
Mailing address
1536 MAIN ST STE 1, PECKVILLE, PA 18452-2062
(570) 291-4450
(570) 291-4454

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC008925
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001998704
BLUE CARE
PA
05
101168716-0001
PA
01
1058062/7225529
AETNA
PA
01
1194780122
GHP FAMILY
PA
01
20045679
AMERIHEALTH
PA
01
78572-1067
GEISINGER
PA
01
854450
OPTUM-UHC
PA
01
P00315312
RAILROAD MEDICARE
PA
Enumeration date
04/20/2006
Last updated
08/17/2021
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