Provider Demographics
NPI:1568726263
Name:AUCKER, BRANDON (DC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:AUCKER
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 1:2205 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-1803
Mailing Address - Country:US
Mailing Address - Phone:570-621-4390
Mailing Address - Fax:570-621-4296
Practice Address - Street 1:2205 W MARKET ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901
Practice Address - Country:US
Practice Address - Phone:570-621-4390
Practice Address - Fax:570-621-4296
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor