Provider Demographics
NPI:1336431105
Name:WASKO CHIROPRACTIC HEALTH CENTER INC
Entity Type:Organization
Organization Name:WASKO CHIROPRACTIC HEALTH CENTER INC
Other - Org Name:ALTERNATIVE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:WASKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-347-7772
Mailing Address - Street 1:3081 INNOVATION WAY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148
Mailing Address - Country:US
Mailing Address - Phone:724-347-7772
Mailing Address - Fax:724-347-7779
Practice Address - Street 1:3881 INNOVATION WAY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-7905
Practice Address - Country:US
Practice Address - Phone:724-347-7772
Practice Address - Fax:724-347-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05003730-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty