Provider Demographics
NPI:1891065298
Name:DRAGAN CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:DRAGAN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DRAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-684-8810
Mailing Address - Street 1:1725 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:MONESSEN
Mailing Address - State:PA
Mailing Address - Zip Code:15062-2240
Mailing Address - Country:US
Mailing Address - Phone:724-684-8810
Mailing Address - Fax:724-684-8856
Practice Address - Street 1:1725 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:MONESSEN
Practice Address - State:PA
Practice Address - Zip Code:15062-2240
Practice Address - Country:US
Practice Address - Phone:724-684-8810
Practice Address - Fax:724-684-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005157L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty