Provider Demographics
NPI:1528215258
Name:O'BRIEN, PHILIP ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ADAM
Last Name:O'BRIEN
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 1:16 WATER WHEEL LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-7454
Mailing Address - Country:US
Mailing Address - Phone:484-894-0254
Mailing Address - Fax:
Practice Address - Street 1:95 HIGHLAND AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9424
Practice Address - Country:US
Practice Address - Phone:484-892-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor