Provider Demographics
NPI:1205927431
Name:ANNETTE CLEMENTE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:ANNETTE CLEMENTE CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:MARICE
Authorized Official - Last Name:CLEMENTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-222-5232
Mailing Address - Street 1:1971 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2639
Mailing Address - Country:US
Mailing Address - Phone:724-222-5232
Mailing Address - Fax:724-225-5141
Practice Address - Street 1:1971 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2639
Practice Address - Country:US
Practice Address - Phone:724-222-5232
Practice Address - Fax:724-225-5141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006834-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty