Provider Demographics
NPI:1366419970
Name:PALLONE, JONATHAN R (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:R
Last Name:PALLONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:700 CRAIGDELL RD
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3366
Mailing Address - Country:US
Mailing Address - Phone:724-337-6568
Mailing Address - Fax:724-337-6550
Practice Address - Street 1:700 CRAIGDELL RD
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-3366
Practice Address - Country:US
Practice Address - Phone:724-337-6568
Practice Address - Fax:724-337-6550
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADL006579L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor