Provider Demographics
NPI:1083187900
Name:SCHALL, BREANNA RAE (DC)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:RAE
Last Name:SCHALL
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 1:140 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-1335
Mailing Address - Country:US
Mailing Address - Phone:724-236-0829
Mailing Address - Fax:724-236-0830
Practice Address - Street 1:140 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-1335
Practice Address - Country:US
Practice Address - Phone:724-236-0829
Practice Address - Fax:724-236-0830
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor