Provider Demographics
NPI:1336474667
Name:MARYLAND HOLISTICS, LLC
Entity Type:Organization
Organization Name:MARYLAND HOLISTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, ACUPUNCTURE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WINDSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, LAC
Authorized Official - Phone:301-588-5858
Mailing Address - Street 1:1111 SPRING ST STE G5
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4028
Mailing Address - Country:US
Mailing Address - Phone:301-588-5858
Mailing Address - Fax:
Practice Address - Street 1:1111 SPRING ST STE G5
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4028
Practice Address - Country:US
Practice Address - Phone:301-588-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251300000XAgenciesLocal Education Agency (LEA)
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health