MEDICARE: MUA ASSOCIATES OF PENNSYLVANIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1699148	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1598971251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUA ASSOCIATES OF PENNSYLVANIA

Provider Business Mailing Address
First Line	:	4605 DIVISION HWY
Second Line	:
City	:	EAST EARL
State	:	PA
Zip	:	17519
Country	:	US
Telephone Number	:	717-355-2940
Fax Number	:	717-355-2940

Provider Business Practice Location Address
First Line	:	4605 DIVISION HWY
Second Line	:
City	:	EAST EARL
State	:	PA
Zip	:	17519
Country	:	US
Telephone Number	:	717-355-2940
Fax Number	:	717-355-2940

Authorized Official
Title or Position	:	CORPORATE OFFICER
Name	:	DR. DANIEL THOEDORE WEST
Credential	:	DC RCRD FABCS FRCCM
Telephone Number	:	717-355-2940

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/14/2009

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Directions to “MUA ASSOCIATES OF PENNSYLVANIA ” Practice Location

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