Provider Demographics
NPI:1982866711
Name:TAORMINA MANAGEMENT, LLC
Entity Type:Organization
Organization Name:TAORMINA MANAGEMENT, LLC
Other - Org Name:WAGNER INTEGRATIVE THERAPES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-230-8100
Mailing Address - Street 1:875 N EASTON RD STE 5B
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1026
Mailing Address - Country:US
Mailing Address - Phone:215-230-8100
Mailing Address - Fax:215-230-8892
Practice Address - Street 1:875 N EASTON RD STE 5B
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1026
Practice Address - Country:US
Practice Address - Phone:215-230-8100
Practice Address - Fax:215-230-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006590L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000858155OtherHIGHMARK BLUE SHIELD
PA1053559567OtherINDIVIDUAL IDENTIFIER
PA0965277000OtherINDEPENDENCE BS
PA1881635159OtherINDIVIDUAL NPI
PA2059271OtherHIGHMARK BLUE SHIELD
PA2059271OtherHIGHMARK BLUE SHIELD