Provider Demographics
NPI:1548354442
Name:RAMSOUR, BRETTNEY ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:BRETTNEY
Middle Name:ROBERT
Last Name:RAMSOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-1307
Mailing Address - Country:US
Mailing Address - Phone:570-476-5577
Mailing Address - Fax:
Practice Address - Street 1:747 MILFORD RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-1307
Practice Address - Country:US
Practice Address - Phone:570-476-5577
Practice Address - Fax:570-476-0260
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU70262Medicare UPIN
PA098870Medicare ID - Type UnspecifiedRAMSOUR FAMILY CHIROPRACT