Healthcare Provider Details
I. General information
NPI: 1023174158
Provider Name (Legal Business Name): CARL WILLIAM OHARA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
622 MAIN ST
FOREST CITY PA
18421-1481
US
IV. Provider business mailing address
622 MAIN ST
FOREST CITY PA
18421-1481
US
V. Phone/Fax
- Phone: 570-586-8525
- Fax: 570-586-8889
- Phone: 570-586-8525
- Fax: 570-586-8889
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC002631-L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | PT002631-L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: