Provider Demographics
NPI:1013593573
Name:OH FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:OH FAMILY CHIROPRACTIC LLC
Other - Org Name:ELDERSBURG FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NYEONGSIG
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-355-6413
Mailing Address - Street 1:1645 LIBERTY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6537
Mailing Address - Country:US
Mailing Address - Phone:443-355-6413
Mailing Address - Fax:
Practice Address - Street 1:1645 LIBERTY RD STE 101
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-6537
Practice Address - Country:US
Practice Address - Phone:443-355-6413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty