Provider Demographics
NPI:1265853394
Name:BOETSCH, HILARY (DC)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:
Last Name:BOETSCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 BURNSIDE ST
Mailing Address - Street 2:APT 2
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-3243
Mailing Address - Country:US
Mailing Address - Phone:941-441-8611
Mailing Address - Fax:
Practice Address - Street 1:8885 CENTRE PARK DR
Practice Address - Street 2:SUITE 2F
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2199
Practice Address - Country:US
Practice Address - Phone:410-740-1112
Practice Address - Fax:410-740-1117
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor