Provider Demographics
NPI:1346275252
Name:ELKRIDGE CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:ELKRIDGE CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KRUPINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-379-8300
Mailing Address - Street 1:6305C WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5348
Mailing Address - Country:US
Mailing Address - Phone:410-379-8300
Mailing Address - Fax:410-379-0228
Practice Address - Street 1:6305C WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5348
Practice Address - Country:US
Practice Address - Phone:410-379-8300
Practice Address - Fax:410-379-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01448261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD180QMedicare PIN