Provider Demographics
NPI:1821094145
Name:TOMALINAS, WILLIAM RAYMOND III (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:TOMALINAS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 S MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-9603
Mailing Address - Country:US
Mailing Address - Phone:570-868-3527
Mailing Address - Fax:
Practice Address - Street 1:685 S MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-9603
Practice Address - Country:US
Practice Address - Phone:570-868-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007091-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA808850OtherFIRST PRIORITY HEALTH
PA974293OtherBLUE CROSS BLUE SHIELD
PAU71579Medicare UPIN
PA013834Medicare ID - Type Unspecified
PA808850OtherFIRST PRIORITY HEALTH