MEDICARE: DR. BRAD ALAN LABUE D.C.

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
1	111N00000X	Chiropractor	DC005325L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	33454	OTHER	PA	GEISENGER HEALTH PLAN
3	000142625	OTHER	PA	PA. BLUE SHIELD (INDIV)

General Provider Information

NPI Number	:	1578544375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAD ALAN LABUE D.C.

Provider Business Mailing Address
First Line	:	200 MCCRACKEN RUN RD
Second Line	:
City	:	DU BOIS
State	:	PA
Zip	:	15801-3634
Country	:	US
Telephone Number	:	814-375-8900
Fax Number	:	814-375-8901

Provider Business Practice Location Address
First Line	:	200 MCCRACKEN RUN RD
Second Line	:
City	:	DU BOIS
State	:	PA
Zip	:	15801-3634
Country	:	US
Telephone Number	:	814-375-8900
Fax Number	:	814-375-8901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	04/20/2018

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