Healthcare Provider Details

I. General information

NPI: 1548241268
Provider Name (Legal Business Name): BRIAN SCOTT HASCHETS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 JOHNSTON RD
BENTLEYVILLE PA
15314-1104
US

IV. Provider business mailing address

104 JOHNSTON RD
BENTLEYVILLE PA
15314-1104
US

V. Phone/Fax

Practice location:
  • Phone: 724-239-2225
  • Fax: 724-239-2250
Mailing address:
  • Phone: 724-239-2225
  • Fax: 724-239-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 005528L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: