Provider Demographics
NPI:1992166474
Name:SLEDZIEWSKI, BETHANN (DC)
Entity type:Individual
Prefix:DR
First Name:BETHANN
Middle Name:
Last Name:SLEDZIEWSKI
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 1:600 N HUNTER HWY
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-2070
Mailing Address - Country:US
Mailing Address - Phone:570-788-4484
Mailing Address - Fax:
Practice Address - Street 1:600 N HUNTER HWY
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2070
Practice Address - Country:US
Practice Address - Phone:570-788-4484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011130111N00000X
PAAJ010894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor