Provider Demographics
NPI:1881814994
Name:FLESCHNER, HAROLD RAYMOND (DCCRP)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:RAYMOND
Last Name:FLESCHNER
Suffix:
Gender:M
Credentials:DCCRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SENECA TRAIL
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970
Mailing Address - Country:US
Mailing Address - Phone:304-645-6524
Mailing Address - Fax:304-645-6524
Practice Address - Street 1:325 SENECA TRAIL
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970
Practice Address - Country:US
Practice Address - Phone:304-645-6524
Practice Address - Fax:304-645-6524
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0132044000Medicaid
WV0132044000Medicaid
T32348Medicare UPIN