Provider Demographics
NPI:1538566773
Name:RUSCZYK, BRITTANY MARIE (DC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:RUSCZYK
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 1:1230 MEMORIAL HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1496
Mailing Address - Country:US
Mailing Address - Phone:570-696-4346
Mailing Address - Fax:
Practice Address - Street 1:1230 MEMORIAL HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-1496
Practice Address - Country:US
Practice Address - Phone:570-696-4346
Practice Address - Fax:570-696-4335
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor