Provider Demographics
NPI:1346442894
Name:MEHL, BRIAN WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WILLIAM
Last Name:MEHL
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 1:26 PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAVALLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:08735-2344
Mailing Address - Country:US
Mailing Address - Phone:732-244-9977
Mailing Address - Fax:732-244-9985
Practice Address - Street 1:716 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6518
Practice Address - Country:US
Practice Address - Phone:732-244-9977
Practice Address - Fax:732-244-9985
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00576800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor