Provider Demographics
NPI:1922417864
Name:SCANLON, JULIE (DC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SCANLON
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 1:175 ADMIRAL COCHRANE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7419
Mailing Address - Country:US
Mailing Address - Phone:443-433-0590
Mailing Address - Fax:443-433-0591
Practice Address - Street 1:227 FERNDALE RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2437
Practice Address - Country:US
Practice Address - Phone:443-618-3912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000886111N00000X
PADC010859111N00000X
MDS03795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor