Healthcare Provider Details

I. General information

NPI: 1154323889
Provider Name (Legal Business Name): STEPHEN JOSEPH WOHAR D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 ROUTE 481
MONONGAHELA PA
15063-3420
US

IV. Provider business mailing address

727 ROUTE 481
MONONGAHELA PA
15063-3420
US

V. Phone/Fax

Practice location:
  • Phone: 724-258-3371
  • Fax: 724-258-3374
Mailing address:
  • Phone: 724-258-3371
  • Fax: 724-258-3374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC004547L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: