Provider Demographics
NPI:1386698017
Name:PIETRANTONE, MICHELLE LEA (DC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEA
Last Name:PIETRANTONE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42882 TRURO PARISH DR
Mailing Address - Street 2:UNIT 207
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4456
Mailing Address - Country:US
Mailing Address - Phone:702-726-9866
Mailing Address - Fax:703-726-9868
Practice Address - Street 1:42882 TRURO PARISH DR
Practice Address - Street 2:UNIT 207
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4456
Practice Address - Country:US
Practice Address - Phone:702-726-9866
Practice Address - Fax:703-726-9868
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor