Provider Demographics
NPI:1073642377
Name:VO, BAO THAI (DC)
Entity Type:Individual
Prefix:DR
First Name:BAO
Middle Name:THAI
Last Name:VO
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 1:7120 CAMPFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4658
Mailing Address - Country:US
Mailing Address - Phone:410-484-1004
Mailing Address - Fax:
Practice Address - Street 1:8860 COLUMBIA 100 PKWY STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2298
Practice Address - Country:US
Practice Address - Phone:410-992-4770
Practice Address - Fax:410-992-4732
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03043111N00000X
VA0104556188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor