Provider Demographics
NPI:1154592566
Name:ORELAND FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:ORELAND FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-885-6695
Mailing Address - Street 1:1330 BRUCE RD
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-1827
Mailing Address - Country:US
Mailing Address - Phone:215-885-6695
Mailing Address - Fax:215-885-6695
Practice Address - Street 1:1330 BRUCE RD
Practice Address - Street 2:
Practice Address - City:ORELAND
Practice Address - State:PA
Practice Address - Zip Code:19075-1827
Practice Address - Country:US
Practice Address - Phone:215-885-6695
Practice Address - Fax:215-885-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006825L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2373476000OtherIBC
PA1699127OtherHIGHMARK BS