Provider Demographics
NPI:1417921875
Name:ERDMAN, DARRON A (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRON
Middle Name:A
Last Name:ERDMAN
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 1:102 QUAIL LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-9325
Mailing Address - Country:US
Mailing Address - Phone:570-966-2021
Mailing Address - Fax:570-966-3106
Practice Address - Street 1:102 QUAIL LN
Practice Address - Street 2:SUITE 1
Practice Address - City:MIFFLINBURG
Practice Address - State:PA
Practice Address - Zip Code:17844-9325
Practice Address - Country:US
Practice Address - Phone:570-966-2021
Practice Address - Fax:570-966-3106
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005034-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAER120548OtherBC/BS NUMBER
PA120548Medicare PIN
441655Medicare UPIN