Provider Demographics
NPI:1811109655
Name:RAMSOUR FAMILY CHIROPRACTIC, PC.
Entity type:Organization
Organization Name:RAMSOUR FAMILY CHIROPRACTIC, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETTNEY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RAMSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-476-5577
Mailing Address - Street 1:747 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-1307
Mailing Address - Country:US
Mailing Address - Phone:570-476-5577
Mailing Address - Fax:
Practice Address - Street 1:747 MILFORD RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-1307
Practice Address - Country:US
Practice Address - Phone:570-476-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005908111N00000X
PADC009339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU08551Medicare UPIN
PAU70262Medicare UPIN
PA098870Medicare ID - Type UnspecifiedRFC ID