Healthcare Provider Details
I. General information
NPI: 1053063545
Provider Name (Legal Business Name): JOSHUA MASORTI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/25/2022
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 W BEAVER AVE STE 3R
STATE COLLEGE PA
16801-4834
US
IV. Provider business mailing address
141 W BEAVER AVE STE 3R
STATE COLLEGE PA
16801-4834
US
V. Phone/Fax
- Phone: 814-380-9582
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC011716 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: