Individual
BRIAN MICHAEL O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
401 S LEHIGH AVE, FRACKVILLE, PA 17931-2436
(570) 874-3530
(570) 874-3283
Mailing address
430 INNOVATION DRIVE, BLAIRSVILLE, PA 15717-8096
(724) 343-4060
(724) 343-4069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT018207
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019541330001
—
PA
01
—
1750492377
ORTHONET
PA
01
—
1878706
HIGHMARK BLUE SHIELD
PA
01
—
232918467
AETNA
PA
01
—
50095047
CAPITAL BLUE CROSS
PA
Enumeration date
08/31/2006
Last updated
01/14/2015
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