Provider Demographics
NPI:1134987407
Name:OASIS SPINE & SPORT PLLC
Entity type:Organization
Organization Name:OASIS SPINE & SPORT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-229-8680
Mailing Address - Street 1:20 RENAISSANCE DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9544
Mailing Address - Country:US
Mailing Address - Phone:724-787-6983
Mailing Address - Fax:
Practice Address - Street 1:200 JAMES PL STE 403
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3408
Practice Address - Country:US
Practice Address - Phone:412-229-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty