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Individual
MR. JOHN RICHARD MISHOCK
Active
Individual
MR. JOHN RICHARD MISHOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC006576L
PA
225100000X
Physical Therapist
Primary
PT012572L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0264322000
DC-KHPE
PA
01
—
0449992000
KEYSTONE HEALTH PLAN EAST
PA
01
—
1962428391
GROUP NPI
PA
01
—
38300034
DC-AETNA
PA
01
—
694511
HIGHMARK
PA
01
—
MI506229
DC-HIGHMARK
PA
Enumeration date
08/16/2005
Last updated
03/17/2008
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