MEDICARE: DR. KORY WAHL DC

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	111N00000X	Chiropractor	CH15644	FL

General Provider Information

NPI Number	:	1609718816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KORY WAHL DC

Provider Business Mailing Address
First Line	:	16766 COURTYARD LOOP
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-3572
Country	:	US
Telephone Number	:	204-799-0569
Fax Number	:

Provider Business Practice Location Address
First Line	:	5711 GULF DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4018
Country	:	US
Telephone Number	:	727-807-7851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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