Provider Demographics
NPI:1699953984
Name:O'BRIEN, GUY CRAIG (DC)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:CRAIG
Last Name:O'BRIEN
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 1:2802 STERRETTANIA RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-3062
Mailing Address - Country:US
Mailing Address - Phone:814-838-8772
Mailing Address - Fax:814-838-8772
Practice Address - Street 1:2802 STERRETTANIA RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3062
Practice Address - Country:US
Practice Address - Phone:814-838-8772
Practice Address - Fax:814-838-8772
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002073L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor