Provider Demographics
NPI:1790853802
Name:PREFERRED CARE CENTER
Entity Type:Organization
Organization Name:PREFERRED CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-766-1144
Mailing Address - Street 1:7389 BALTIMORE ANNAPOLIS BLVD STE L
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7389 BALTIMORE ANNAPOLIS BLVD STE L
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3228
Practice Address - Country:US
Practice Address - Phone:410-766-1144
Practice Address - Fax:410-766-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD480MMedicare ID - Type Unspecified