Provider Demographics
NPI:1508928466
Name:FARLEY, DAVID BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:FARLEY
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 1:1443 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6632
Mailing Address - Country:US
Mailing Address - Phone:401-942-5625
Mailing Address - Fax:401-942-6582
Practice Address - Street 1:1443 PARK AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6632
Practice Address - Country:US
Practice Address - Phone:401-942-5625
Practice Address - Fax:401-942-6582
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007010425Medicare ID - Type Unspecified