Provider Demographics
NPI:1649279985
Name:HOSAFLOOK, DAVID ERIC (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ERIC
Last Name:HOSAFLOOK
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 1:500 MOUNT JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16102-2618
Mailing Address - Country:US
Mailing Address - Phone:724-667-7160
Mailing Address - Fax:724-667-8807
Practice Address - Street 1:500 MOUNT JACKSON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16102-2618
Practice Address - Country:US
Practice Address - Phone:724-667-7160
Practice Address - Fax:724-667-8807
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004657-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U18596Medicare UPIN
PANXU672234Medicare ID - Type Unspecified