Provider Demographics
NPI:1225034523
Name:KLIAMOVICH, JAMES ADAM II (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ADAM
Last Name:KLIAMOVICH
Suffix:II
Gender:M
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:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:SWEET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18656-0334
Mailing Address - Country:US
Mailing Address - Phone:570-477-2778
Mailing Address - Fax:570-477-3572
Practice Address - Street 1:5321 MAIN ROAD
Practice Address - Street 2:
Practice Address - City:SWEET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18656-0334
Practice Address - Country:US
Practice Address - Phone:570-477-2778
Practice Address - Fax:570-477-3572
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006235L111N00000X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA339411OtherADVANTRA FREEDOM
PA0015407230003Medicaid
PA0814753000OtherINDEPENDENCE BLUE CROSS
PA1007640OtherASHN
PA20039719OtherAMERIHEALTH MERCY
PA2983739OtherCIGNA HEALTHCARE
PA789959OtherHIGHMARK BC/BS
PA2194938OtherFIRST HEALTH
PA45223OtherGEISINGER HEALTH PLAN
PA118377OtherUNISON HEALTH PLAN
PA5622279OtherAETNA PPO ID
PA825782OtherFIRST PRIORITY HEALTH
PA611305800OtherUS DEPT. OF LABOR
PA2298072OtherAETNA HMO ID
PA339411OtherHEALTH AMERICA
PA350052217OtherRAILROAD MEDICARE NO.
PA350052217OtherRAILROAD MEDICARE
PA789959OtherFIRST PRIORITY LIFE INS
PA118377OtherUNISON HEALTH PLAN
PA2983739OtherCIGNA HEALTHCARE