Provider Demographics
NPI:1194866012
Name:BERTOLINE, JULIA (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:BERTOLINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3424 WILLIAM PENN HWY
Mailing Address - Street 2:SUITE #168
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5444
Mailing Address - Country:US
Mailing Address - Phone:412-823-2180
Mailing Address - Fax:412-823-6165
Practice Address - Street 1:3424 WILLIAM PENN HWY
Practice Address - Street 2:SUITE #168
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5444
Practice Address - Country:US
Practice Address - Phone:412-823-2180
Practice Address - Fax:412-823-6165
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006365L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098723Medicare ID - Type Unspecified
PAU72296Medicare UPIN