Provider Demographics
NPI:1184873168
Name:GREENSFELDER CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:GREENSFELDER CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREENSFELDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-674-8605
Mailing Address - Street 1:1350 BLAIR DR STE HH
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1333
Mailing Address - Country:US
Mailing Address - Phone:410-674-8605
Mailing Address - Fax:410-674-8608
Practice Address - Street 1:1350 BLAIR DR STE HH
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1333
Practice Address - Country:US
Practice Address - Phone:410-674-8605
Practice Address - Fax:410-674-8608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD150PMedicare PIN