Healthcare Provider Details

I. General information

NPI: 1134081136
Provider Name (Legal Business Name): DR. EVAN JAMES HOHERCHAK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2025
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 DELAWARE ST
HONESDALE PA
18431-1150
US

IV. Provider business mailing address

200 DELAWARE ST
HONESDALE PA
18431-1150
US

V. Phone/Fax

Practice location:
  • Phone: 570-253-9039
  • Fax:
Mailing address:
  • Phone: 570-253-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC012088
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: