Provider Demographics
NPI:1083811822
Name:PLACEK, BRIAN LEWIS (AS, BS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:LEWIS
Last Name:PLACEK
Suffix:
Gender:M
Credentials:AS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-0161
Mailing Address - Country:US
Mailing Address - Phone:877-372-0066
Mailing Address - Fax:877-372-0066
Practice Address - Street 1:14041 CHARLES DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-8760
Practice Address - Country:US
Practice Address - Phone:877-372-0066
Practice Address - Fax:877-372-0066
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide