Provider Demographics
NPI:1558618249
Name:BRIAN K. DRAGAN, D.C.
Entity Type:Organization
Organization Name:BRIAN K. DRAGAN, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DRAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-766-1444
Mailing Address - Street 1:502 FOREST VIEW RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2818
Mailing Address - Country:US
Mailing Address - Phone:443-310-8613
Mailing Address - Fax:410-768-5703
Practice Address - Street 1:7575 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3716
Practice Address - Country:US
Practice Address - Phone:410-766-1444
Practice Address - Fax:410-768-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01433111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty