Provider Demographics
NPI:1154608701
Name:MCCAULEY, BRENT CLAYTON (DC)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:CLAYTON
Last Name:MCCAULEY
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 1:106 WESTPOINT DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5965
Mailing Address - Country:US
Mailing Address - Phone:724-836-2200
Mailing Address - Fax:
Practice Address - Street 1:106 WESTPOINT DR
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5965
Practice Address - Country:US
Practice Address - Phone:724-836-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor