Provider Demographics
NPI:1083814115
Name:HALLMAN, RANDY (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:HALLMAN
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 1:3401 ERDMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1945
Mailing Address - Country:US
Mailing Address - Phone:410-276-9222
Mailing Address - Fax:410-276-9119
Practice Address - Street 1:3401 ERDMAN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1945
Practice Address - Country:US
Practice Address - Phone:410-276-9222
Practice Address - Fax:410-276-9119
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor