Provider Demographics
NPI:1174854673
Name:SALISBURY CHIROPRACTIC
Entity Type:Organization
Organization Name:SALISBURY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-749-6672
Mailing Address - Street 1:305 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4218
Mailing Address - Country:US
Mailing Address - Phone:410-749-6672
Mailing Address - Fax:410-860-5387
Practice Address - Street 1:305 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4218
Practice Address - Country:US
Practice Address - Phone:410-749-6672
Practice Address - Fax:410-860-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM177Medicare PIN