Provider Demographics
NPI:1528182276
Name:PEHONSKY, WENDY R (DC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:R
Last Name:PEHONSKY
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 1:1705 N JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1919
Mailing Address - Country:US
Mailing Address - Phone:814-695-5699
Mailing Address - Fax:814-695-5618
Practice Address - Street 1:310 PENN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2044
Practice Address - Country:US
Practice Address - Phone:814-695-5699
Practice Address - Fax:814-695-5618
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC8661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019229230001Medicaid
PA0019229230001Medicaid
U92454Medicare UPIN