Provider Demographics
NPI:1184940710
Name:R T POANELLC
Entity type:Organization
Organization Name:R T POANELLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:POANE
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:410-420-7676
Mailing Address - Street 1:1 BARRINGTON PL
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5607
Mailing Address - Country:US
Mailing Address - Phone:410-420-7676
Mailing Address - Fax:410-420-7677
Practice Address - Street 1:1 BARRINGTON PL
Practice Address - Street 2:SUITE 108
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5607
Practice Address - Country:US
Practice Address - Phone:410-420-7676
Practice Address - Fax:410-420-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1214111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty