Provider Demographics
NPI:1174564272
Name:CALCAGNI, BRIAN LEWIS (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:LEWIS
Last Name:CALCAGNI
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 1:223 NORTH MAPLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-837-6717
Mailing Address - Fax:724-837-6717
Practice Address - Street 1:223 NORTH MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-837-6717
Practice Address - Fax:724-837-6717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003925L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA182199Medicare ID - Type Unspecified
T84852Medicare UPIN