Provider Demographics
NPI:1275600520
Name:HUSS, DEAN RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:RICHARD
Last Name:HUSS
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 1:423 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:PA
Mailing Address - Zip Code:15627-1660
Mailing Address - Country:US
Mailing Address - Phone:724-695-5595
Mailing Address - Fax:724-539-4075
Practice Address - Street 1:5927 STATE ROUTE 981
Practice Address - Street 2:SUITE 2
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2687
Practice Address - Country:US
Practice Address - Phone:724-694-5595
Practice Address - Fax:724-539-4075
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007151L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAHU470474OtherBLUE CROSS BLUE SHILED
PA0676721Medicaid
PAU76752Medicare UPIN
PAHU470474OtherBLUE CROSS BLUE SHILED