Provider Demographics
NPI:1851489819
Name:STUDER, BRIAN C (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:STUDER
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 1:2106 NORTH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1241
Mailing Address - Country:US
Mailing Address - Phone:440-240-9390
Mailing Address - Fax:440-240-9370
Practice Address - Street 1:2106 NORTH RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1241
Practice Address - Country:US
Practice Address - Phone:440-240-9390
Practice Address - Fax:440-240-9370
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2432273Medicaid
OHST4123092Medicare ID - Type UnspecifiedBOX 24
OHU97856Medicare UPIN
OH2432273Medicaid
OH4123092Medicare PIN