Provider Demographics
NPI:1972640993
Name:BRUBAKER, REBECCA ANNE-STOEHR (DC)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE-STOEHR
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:FALLS CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15840
Mailing Address - Country:US
Mailing Address - Phone:814-375-9888
Mailing Address - Fax:
Practice Address - Street 1:52 MAIN ST.
Practice Address - Street 2:
Practice Address - City:FALLS CREEK
Practice Address - State:PA
Practice Address - Zip Code:15840
Practice Address - Country:US
Practice Address - Phone:814-375-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1728584OtherHIGHMARK BLUE CROSS
PA094308ULAMedicare ID - Type Unspecified
PA1728584OtherHIGHMARK BLUE CROSS