Provider Demographics
NPI:1245217595
Name:MAHLER, PAUL RAYMOND JR (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:RAYMOND
Last Name:MAHLER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1144 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:FORTY FORT
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4015
Mailing Address - Country:US
Mailing Address - Phone:570-283-1610
Mailing Address - Fax:570-338-6974
Practice Address - Street 1:1144 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4015
Practice Address - Country:US
Practice Address - Phone:570-283-1610
Practice Address - Fax:570-338-6974
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA817976OtherFIRST PRIORITY BC/BS NEPA
053005U8ROtherMEDICARE PTAN
PA0018774160001Medicaid
PA043648674OtherDEVON
PA1334931OtherBLUE CROSS/ BLUE SHEILD
PAU87885Medicare UPIN
PA817976OtherFIRST PRIORITY BC/BS NEPA