Healthcare Provider Details

I. General information

NPI: 1376599068
Provider Name (Legal Business Name): DANIEL W MILEFSKY JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W CENTRE ST
MAHANOY CITY PA
17948-2605
US

IV. Provider business mailing address

107 W CENTRE ST
MAHANOY CITY PA
17948-2605
US

V. Phone/Fax

Practice location:
  • Phone: 570-773-2690
  • Fax: 570-773-2691
Mailing address:
  • Phone: 570-773-2690
  • Fax: 570-773-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007306L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: