Individual
DR. JOHN D WANYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
68 MAIN ST, LUZERNE, PA 18709-1210
(570) 288-0629
(570) 283-0367
Mailing address
68 MAIN ST, LUZERNE, PA 18709-1210
(570) 288-0629
(570) 283-0367
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
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