Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC005402R | PA |
N | 111NR0400X | Rehabilitation Chiropractor | DC005402R | PA |
NPI | 1336367291 |
---|---|
Provider Name | Dr. Dianna Lynne Rafferty |
First Address | Uniontown, PA 15401-6220 |
Second Address | Uniontown, PA 15401-6220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RA1420259 | HIGHMARK (01) | PA |