Wyoming Valley Family Chiropractic Center
Organization Active NPI Chiropractor · Forty Fort, PA
NPI 1861575441 · NPPES record last updated Feb 20, 2024
Key facts
- NPI
- 1861575441
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC008627 (PA)
- Legal business name
- WYOMING VALLEY FAMILY CHIROPRACTIC CENTER
- Practice address
- 1144 Wyoming Ave
Forty Fort, PA 18704-4015 - Phone
- (570) 283-1610
- Fax
- (570) 763-4134
- NPI assigned
- Oct 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Paul Raymond Mahler Jr., D.C.
- Title
- Owner
- Phone
- (570) 283-1610
Practitioners 2
-
Paul Raymond Mahler Jr., D.C.
-
Gary Peter McGee, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060405000329 | PA | Part B Supplier - Clinic/Group Practice | 2365450129 |
Receives reassigned benefits from 1 practitioner Practice locations: Forty Fort, PA |
National Provider Directory
Locations
1144 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-1610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC008627 | PA | Yes |
Addresses
Primary practice location
1144 Wyoming Ave
Forty Fort, PA 18704-4015
Mailing address
1144 Wyoming Ave
Forty Fort, PA 18704-4015
Phone (570) 283-1610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001877416003 | Medicaid | PA | |
| 817976 | Other | PA | FIRST PRIORITY |
| 1828303 | Other | PA | BC/ BS |
Other names
- Mahler Family Chiropractic Center
Other providers in Forty Fort, PA
- Erin Williams
- Emily Witts
- Aimee-Lee Wright
- Wyoming Valley Childrens Association
- Wyoming Valley Chiropractic Inc
- Wyoming Valley Pet Associates
- Alexandra Yanez
- Maya Yoder
- Joshua S Yoh
- Kari Marie Youngblood
All providers in Forty Fort, PA · Chiropractor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.