Individual
DR. JERRY STEVEN SANGIAMO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
317 GORDON DR, EXTON, PA 19341-1201
(610) 594-8522
(610) 594-6499
Mailing address
392 DEVON DR, EXTON, PA 19341-1781
(610) 594-8522
(610) 594-6499
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC005947L
PA
111N00000X
Chiropractor
X004477
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0233920000/043102600
PERSONAL CHOICE
PA
01
—
0431026000
B/C B/S
PA
01
—
SA028047
COMMERCIAL
PA
01
—
U72312
TRICARE
PA
Enumeration date
05/18/2006
Last updated
07/09/2007
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