Provider Demographics
NPI:1831114107
Name:HALTEMAN, RONALD LLOYD (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LLOYD
Last Name:HALTEMAN
Suffix:
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 1:745 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7519
Mailing Address - Country:US
Mailing Address - Phone:610-326-1967
Mailing Address - Fax:610-326-1264
Practice Address - Street 1:745 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7519
Practice Address - Country:US
Practice Address - Phone:610-326-1967
Practice Address - Fax:610-326-1264
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001071L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA115929Medicare UPIN