Provider Demographics
NPI:1205068426
Name:STAKER, BRYAN CURTUS (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:CURTUS
Last Name:STAKER
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 1:761 5TH AVE
Mailing Address - Street 2:# F
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4210
Mailing Address - Country:US
Mailing Address - Phone:717-263-6101
Mailing Address - Fax:
Practice Address - Street 1:761 5TH AVE
Practice Address - Street 2:# F
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4210
Practice Address - Country:US
Practice Address - Phone:717-263-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor