Provider Demographics
NPI:1851677363
Name:NERAC THERAPEUTIC TOUCH
Entity Type:Organization
Organization Name:NERAC THERAPEUTIC TOUCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLIFT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:301-442-4882
Mailing Address - Street 1:PO BOX 6567
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20792-6567
Mailing Address - Country:US
Mailing Address - Phone:301-442-4882
Mailing Address - Fax:
Practice Address - Street 1:860 LARGO CENTER DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-3705
Practice Address - Country:US
Practice Address - Phone:301-442-4882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM02449261QP3300X, 261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation