Provider Demographics
NPI:1659554236
Name:LA PLATA FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:LA PLATA FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-932-2100
Mailing Address - Street 1:203 CENTENNIAL STREET
Mailing Address - Street 2:SUITE105
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646
Mailing Address - Country:US
Mailing Address - Phone:301-932-2100
Mailing Address - Fax:301-392-9338
Practice Address - Street 1:203 CENTENNIAL
Practice Address - Street 2:SUITE 106
Practice Address - City:LAPLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-2741
Practice Address - Country:US
Practice Address - Phone:301-932-2100
Practice Address - Fax:301-392-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1429MD111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU56128Medicare UPIN
MD243MMedicare PIN
MDT52832Medicare UPIN