Provider Demographics
NPI:1376092544
Name:KASUN, MARIAH K (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIAH
Middle Name:K
Last Name:KASUN
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 1:1114 WALTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-2748
Mailing Address - Country:US
Mailing Address - Phone:814-342-3591
Mailing Address - Fax:
Practice Address - Street 1:1114 WALTON ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-2748
Practice Address - Country:US
Practice Address - Phone:814-342-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0007487111N00000X
PADC011286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor