Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1555 | OH |
NPI | 1144217548 |
---|---|
Provider Name | Dr. James S. Depietro |
First Address | Lancaster, OH 43130-8821 |
Second Address | Lancaster, OH 43130-8821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 21/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0114683 | (05) | OH |
350032426 | RAILROAD PIN ID (01) | OH |