Provider Demographics
NPI:1790957363
Name:NEWMAN, JEAN M (DC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:NEWMAN
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:PO BOX 4260
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:PA
Mailing Address - Zip Code:18644-1919
Mailing Address - Country:US
Mailing Address - Phone:570-693-0480
Mailing Address - Fax:570-693-0481
Practice Address - Street 1:525 MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:PA
Practice Address - Zip Code:18644-1919
Practice Address - Country:US
Practice Address - Phone:570-693-0480
Practice Address - Fax:570-693-0481
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002598 L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor