Provider Demographics
NPI:1710221874
Name:DABBS ACCELERATED BACK CARE PROGRAM. LLC
Entity Type:Organization
Organization Name:DABBS ACCELERATED BACK CARE PROGRAM. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VAUGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DABBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-720-5555
Mailing Address - Street 1:8600 SNOWDEN RIVER PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1982
Mailing Address - Country:US
Mailing Address - Phone:410-720-5555
Mailing Address - Fax:410-381-4653
Practice Address - Street 1:8600 SNOWDEN RIVER PKWY
Practice Address - Street 2:STE 101
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1982
Practice Address - Country:US
Practice Address - Phone:410-720-5555
Practice Address - Fax:410-381-4653
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHAB CENTER OF MD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty