Provider Demographics
NPI:1013227859
Name:LIBERTY MEDICAL & INJURY CENTER
Entity Type:Organization
Organization Name:LIBERTY MEDICAL & INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-580-9191
Mailing Address - Street 1:7034 LIBERTY RD.
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207
Mailing Address - Country:US
Mailing Address - Phone:410-580-9191
Mailing Address - Fax:410-580-9393
Practice Address - Street 1:7034 LIBERTY RD.
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207
Practice Address - Country:US
Practice Address - Phone:410-580-9191
Practice Address - Fax:410-580-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty