Provider Demographics
NPI:1548563190
Name:DAVID G WASCHER D.C., P.C.
Entity Type:Organization
Organization Name:DAVID G WASCHER D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:WASCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-326-3393
Mailing Address - Street 1:1905 MILL LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1527
Mailing Address - Country:US
Mailing Address - Phone:570-326-3393
Mailing Address - Fax:570-326-3324
Practice Address - Street 1:1905 MILL LN
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1527
Practice Address - Country:US
Practice Address - Phone:570-326-3393
Practice Address - Fax:570-326-3324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-001320L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA115649Medicare PIN