Provider Demographics
NPI:1346304821
Name:SALBERG, ORYAN (DC)
Entity Type:Individual
Prefix:
First Name:ORYAN
Middle Name:
Last Name:SALBERG
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 1:202 N GRANITE ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3026
Mailing Address - Country:US
Mailing Address - Phone:928-445-2004
Mailing Address - Fax:
Practice Address - Street 1:202 N GRANITE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3026
Practice Address - Country:US
Practice Address - Phone:928-445-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5956111N00000X
AZ3566111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ73443Medicare ID - Type Unspecified
AZU75525Medicare UPIN