Provider Demographics
NPI:1194845578
Name:DOBRICH, ANDREA JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JEAN
Last Name:DOBRICH
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:PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0848
Mailing Address - Country:US
Mailing Address - Phone:704-455-6505
Mailing Address - Fax:
Practice Address - Street 1:116 CANDYSTICK CIRCLE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075
Practice Address - Country:US
Practice Address - Phone:704-455-6505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0007741575OtherAETNA
NC085PROtherBCBS
NC89085PRMedicaid
NC0007741575OtherAETNA