Provider Demographics
NPI:1578105623
Name:LEVEL UP SPINE CARE AND REHAB
Entity Type:Organization
Organization Name:LEVEL UP SPINE CARE AND REHAB
Other - Org Name:LEVEL UP SPINE CARE AND REHAB
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:JOMAR
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:443-871-6282
Mailing Address - Street 1:5419 DEALE CHURCHTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CHURCHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20733-2408
Mailing Address - Country:US
Mailing Address - Phone:443-607-4908
Mailing Address - Fax:443-203-6575
Practice Address - Street 1:5419 DEALE CHURCHTON RD STE 102
Practice Address - Street 2:
Practice Address - City:CHURCHTON
Practice Address - State:MD
Practice Address - Zip Code:20733-2408
Practice Address - Country:US
Practice Address - Phone:443-607-4908
Practice Address - Fax:443-203-6575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty