Provider Demographics
NPI:1922089317
Name:WASCHER, DARRIN L (DC)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:L
Last Name:WASCHER
Suffix:
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 1:2403 LYCOMING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1163
Mailing Address - Country:US
Mailing Address - Phone:570-494-1133
Mailing Address - Fax:570-494-1133
Practice Address - Street 1:2403 LYCOMING CREEK RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1163
Practice Address - Country:US
Practice Address - Phone:570-494-1133
Practice Address - Fax:570-494-1133
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004739-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU20340Medicare UPIN
PA036559TGBMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #