Provider Demographics
NPI:1538202304
Name:STRASISER, TONY W (DC)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:W
Last Name:STRASISER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3371 SEANOR RD
Mailing Address - Street 2:
Mailing Address - City:HOLLSOPPLE
Mailing Address - State:PA
Mailing Address - Zip Code:15935-8606
Mailing Address - Country:US
Mailing Address - Phone:814-479-2561
Mailing Address - Fax:814-479-2935
Practice Address - Street 1:3371 SEANOR RD
Practice Address - Street 2:
Practice Address - City:HOLLSOPPLE
Practice Address - State:PA
Practice Address - Zip Code:15935-8606
Practice Address - Country:US
Practice Address - Phone:814-479-2561
Practice Address - Fax:814-479-2935
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004249L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012245900004Medicaid
PA0012245900004Medicaid
PA640097Medicare ID - Type Unspecified