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Individual

DR. THOMAS C MACK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
116 W SMITH ST, CORRY, PA 16407-1558
(814) 665-1032
(814) 665-2225
Mailing address
116 W SMITH ST, CORRY, PA 16407-1558
(814) 665-1032
(814) 665-2225

Taxonomy

Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
DC003097L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
155842
HEALTH AMERICA
PA
01
456615
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
01/23/2006
Last updated
07/08/2007
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