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NPI Code Detail

MEDICARE: BRIAN BIRD DC

MEDICARE: BRIAN BIRD DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC006825LPA

General Provider Information

NPI Number : 1548278179
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN BIRD DC
Provider Business Mailing Address
First Line : 450 PARK WAY
Second Line : SUITE 300
City : BROOMALL
State : PA
Zip : 19008-4202
Country : US
Telephone Number : 484-422-8080
Fax Number : 484-422-8073
Provider Business Practice Location Address
First Line : 901 W ASHLAND AVE
Second Line :
City : GLENOLDEN
State : PA
Zip : 19036-1101
Country : US
Telephone Number : 610-461-6450
Fax Number : 610-461-1842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 07/20/2010

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Directions to “ BRIAN BIRD DC” Practice Location

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