Provider Demographics
NPI:1558838755
Name:ADVANCED HEALTH AND REHABILITATION OF NEW BERN
Entity Type:Organization
Organization Name:ADVANCED HEALTH AND REHABILITATION OF NEW BERN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-321-3579
Mailing Address - Street 1:504 RED BANKS RD STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5766
Mailing Address - Country:US
Mailing Address - Phone:252-321-3579
Mailing Address - Fax:252-321-3576
Practice Address - Street 1:3338 WELLONS BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5290
Practice Address - Country:US
Practice Address - Phone:252-631-5353
Practice Address - Fax:252-631-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty