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Individual

DR. JOHN D WANYO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC002182L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007675810001
PA
01
0042660000
INDEPENDENCE BLUE CROSS
PA
01
093081
FIRST PRIORITY HEALTH
PA
01
11583801
CAQH
PA
01
350002549
PALMETTO GBA
PA
01
WA1626351
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/13/2006
Last updated
10/03/2007
Update your record

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