Provider Demographics
NPI:1326312687
Name:INFANTI CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:INFANTI CHIROPRACTIC, INC.
Other - Org Name:CHIRO 1ST CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:INFANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-573-5733
Mailing Address - Street 1:134 HOLIDAY CT
Mailing Address - Street 2:STE. 309
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7008
Mailing Address - Country:US
Mailing Address - Phone:410-573-5733
Mailing Address - Fax:410-897-9118
Practice Address - Street 1:134 HOLIDAY CT
Practice Address - Street 2:STE. 309
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7008
Practice Address - Country:US
Practice Address - Phone:410-573-5733
Practice Address - Fax:410-897-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD480QMedicare PIN