Organization
DICELLO CHIROPRACTIC CARE, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINA MARIE DICELLO D. C. (PRESIDENT)
(570) 622-1170
Entity
Organization
Contact information
Practice address
1825 W MARKET ST, POTTSVILLE, PA 17901-2001
(570) 622-1170
Mailing address
1825 W MARKET ST, POTTSVILLE, PA 17901-2001
(570) 622-1170
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006181-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008742
INDEPENDANCE BLUE SHIELD
PA
01
—
2187051
AETNA ID NUMBER
PA
01
—
4242090001
MEDICARE DME PROVIDER NO
PA
01
—
P4384000
OXFORD ID NUMBER
PA
Enumeration date
03/08/2007
Last updated
08/22/2020
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