Provider Demographics
NPI:1780575076
Name:MASTELLER, DIANA ROSE (DC)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:ROSE
Last Name:MASTELLER
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 1:820 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NESCOPECK
Mailing Address - State:PA
Mailing Address - Zip Code:18635-1407
Mailing Address - Country:US
Mailing Address - Phone:570-759-7009
Mailing Address - Fax:570-759-8099
Practice Address - Street 1:820 E 3RD ST
Practice Address - Street 2:
Practice Address - City:NESCOPECK
Practice Address - State:PA
Practice Address - Zip Code:18635-1407
Practice Address - Country:US
Practice Address - Phone:570-759-7009
Practice Address - Fax:570-759-8099
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC012049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor