Provider Demographics
NPI:1831383769
Name:MIHALKO, STACEY LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:LYNN
Last Name:MIHALKO
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 1:217 FRANKLIN AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071-1521
Mailing Address - Country:US
Mailing Address - Phone:610-826-4136
Mailing Address - Fax:610-824-6515
Practice Address - Street 1:217 FRANKLIN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-1521
Practice Address - Country:US
Practice Address - Phone:610-826-4136
Practice Address - Fax:610-824-6515
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007606L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU77710Medicare UPIN