Provider Demographics
NPI:1669483376
Name:HINKLE, LISA MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MICHELLE
Last Name:HINKLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N BENTZ ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4982
Mailing Address - Country:US
Mailing Address - Phone:301-662-4220
Mailing Address - Fax:301-662-8195
Practice Address - Street 1:605 N BENTZ ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4982
Practice Address - Country:US
Practice Address - Phone:301-662-4220
Practice Address - Fax:301-662-8195
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD565MMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER