Provider Demographics
NPI:1225161722
Name:HEALING HANDS CHIROPRACTIC HEALTH CARE PC
Entity Type:Organization
Organization Name:HEALING HANDS CHIROPRACTIC HEALTH CARE PC
Other - Org Name:BETH TEDESCO DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:BOSTON
Authorized Official - Last Name:TEDESCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-424-0220
Mailing Address - Street 1:14804 PHYSICIANS LANE SUITE 222
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-424-0220
Mailing Address - Fax:301-424-7262
Practice Address - Street 1:14804 PHYSICIANS LANE SUITE 222
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-424-0220
Practice Address - Fax:301-424-7262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01979Medicare ID - Type Unspecified
U48434Medicare UPIN