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Individual

DR. JASON MICHAEL DEPIETROPAOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
520 S MAIN ST, OLD FORGE, PA 18518-1542
(570) 457-0977
(570) 457-1279
Mailing address
19 CAREY LN, PITTSTON, PA 18640-3225
(570) 655-8887
(570) 457-1279

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-007551-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018139920001
PA
01
720512
BLUE SHIELD
PA
Enumeration date
03/14/2006
Last updated
08/27/2007
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