Provider Demographics
NPI:1174676431
Name:MORELAND, BRIAN (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MORELAND
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 1:1404 THISTLE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8834
Mailing Address - Country:US
Mailing Address - Phone:724-516-3891
Mailing Address - Fax:
Practice Address - Street 1:RR 7 BOX 812
Practice Address - Street 2:CROSSROADS PLAZA
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-8900
Practice Address - Country:US
Practice Address - Phone:724-547-1800
Practice Address - Fax:724-547-1802
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009164111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1579647OtherBLUE SHIELD
GAP00159430OtherTRAVELER'S MEDICARE
GAP00159430OtherTRAVELER'S MEDICARE
PA1579647OtherBLUE SHIELD