Provider Demographics
NPI:1487736716
Name:BEEGLE, BRADLEY J (DC)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:J
Last Name:BEEGLE
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 1:255 BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2315
Mailing Address - Country:US
Mailing Address - Phone:717-334-5500
Mailing Address - Fax:717-334-9107
Practice Address - Street 1:255 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2315
Practice Address - Country:US
Practice Address - Phone:717-334-5500
Practice Address - Fax:717-334-9107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004113L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA330922OtherCOMBINED INSURANCE
PW581393OtherHIGHMARK BLUE SHIELD
PAAS17162130001OtherCIGNA
PA02562400OtherCAPITAL BLUE CROSS
PAAS17162130001OtherCIGNA
PW581393OtherHIGHMARK BLUE SHIELD