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General NPI Number Information
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NPI Number | 1366423949
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING CHIROPRACTIC, LLC.
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 2403 LYCOMING CREEK RD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1163
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Country | US
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Telephone | 570-494-1133
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Fax | 570-494-1133
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Provider Business Mailing Address
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Address Line | 2403 LYCOMING CREEK RD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1163
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Country | US
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Telephone | 570-494-1133
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Fax | 570-494-1133
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. DARRIN L. WASCHER
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Credential | D.C.
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Telephone | 570-494-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-004739-L
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License Number State | PA
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