Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC009933 | PA |
Y | 111NN0400X | Neurology | DC009933 | PA |
NPI | 1558533091 |
---|---|
Provider Name | Dr. John W. Farabaugh |
First Address | Johnstown, PA 15905-3400 |
Second Address | Johnstown, PA 15905-3400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2008 |
Last Update Date | 25/06/2019 |