Healthcare Provider Details

I. General information

NPI: 1174676431
Provider Name (Legal Business Name): BRIAN MORELAND D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 7 BOX 812 CROSSROADS PLAZA
MT PLEASANT PA
15666-8900
US

IV. Provider business mailing address

1404 THISTLE DR
GREENSBURG PA
15601-8834
US

V. Phone/Fax

Practice location:
  • Phone: 724-547-1800
  • Fax: 724-547-1802
Mailing address:
  • Phone: 724-516-3891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC009164
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: