| |
607 Oakland Ave, Mountain Lake Park, MD 21550-3734 | |
(301) 334-3180 | |
(301) 334-3182 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 607 Oakland Ave, Mountain Lake Park, Maryland |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699985036 | NPI | - | NPPES |
0131153000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | S01108 (Maryland) | Primary |
Mailing Address | Practice Location Address |
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607 Oakland Ave, Mountain Lake Park, MD 21550-3734 Ph: (301) 334-3180 | 607 Oakland Ave, Mountain Lake Park, MD 21550-3734 Ph: (301) 334-3180 |