Provider Demographics
NPI:1073579249
Name:DREHER, DARREN ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:ERIC
Last Name:DREHER
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 1:963 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-9752
Mailing Address - Country:US
Mailing Address - Phone:570-385-2860
Mailing Address - Fax:570-385-3576
Practice Address - Street 1:963 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-9752
Practice Address - Country:US
Practice Address - Phone:570-385-2860
Practice Address - Fax:570-385-3576
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004799L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02875900OtherCAPITAL BLUE CROSS PROVID
PA725217Medicare ID - Type UnspecifiedPROVIDER ID
PAU32190Medicare UPIN