Provider Demographics
NPI:1649398702
Name:DOYLE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:DOYLE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VEENA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-292-1960
Mailing Address - Street 1:12805 OLD FORT RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2874
Mailing Address - Country:US
Mailing Address - Phone:301-292-1960
Mailing Address - Fax:301-292-1068
Practice Address - Street 1:12805 OLD FORT RD
Practice Address - Street 2:SUITE 202
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-2874
Practice Address - Country:US
Practice Address - Phone:301-292-1960
Practice Address - Fax:301-292-1068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01284OtherMEDICARE GROUP