Provider Demographics
NPI:1003388372
Name:POEHLMAN, ELLIOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:
Last Name:POEHLMAN
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 1:38 BLOOMSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4858
Mailing Address - Country:US
Mailing Address - Phone:410-788-2225
Mailing Address - Fax:410-788-0633
Practice Address - Street 1:38 BLOOMSBURY AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4858
Practice Address - Country:US
Practice Address - Phone:410-788-2225
Practice Address - Fax:410-788-0633
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03986111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor