Provider Demographics
NPI:1750712253
Name:ARDO, ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ARDO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:SCATENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:535 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NESCOPECK
Mailing Address - State:PA
Mailing Address - Zip Code:18635-1306
Mailing Address - Country:US
Mailing Address - Phone:570-498-0886
Mailing Address - Fax:
Practice Address - Street 1:1000 MARKET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-2600
Practice Address - Country:US
Practice Address - Phone:570-498-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010806111N00000X
PAAJ010590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor