Provider Demographics
NPI:1508035031
Name:BRAUN, EVAN
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:BRAUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BIERER LN
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3117
Mailing Address - Country:US
Mailing Address - Phone:412-417-3328
Mailing Address - Fax:
Practice Address - Street 1:105 BIERER LN
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3117
Practice Address - Country:US
Practice Address - Phone:412-417-3328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor