Provider Demographics
NPI:1578622882
Name:OSANSKY, ERIC MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MARK
Last Name:OSANSKY
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:PO BOX 1062
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-1062
Mailing Address - Country:US
Mailing Address - Phone:704-996-1290
Mailing Address - Fax:888-380-1153
Practice Address - Street 1:4100 CARMEL RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-6151
Practice Address - Country:US
Practice Address - Phone:888-570-8873
Practice Address - Fax:888-380-1153
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0844TOtherBLUE CROSS BLUE SHIELD
NC0844TOtherBLUE CROSS BLUE SHIELD