Provider Demographics
NPI:1245537703
Name:HEALING CHIROPRACTIC AND REHAB CENTER
Entity type:Organization
Organization Name:HEALING CHIROPRACTIC AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIORPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JINHO
Authorized Official - Middle Name:
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:213-219-1915
Mailing Address - Street 1:481 N FREDERICK AVE
Mailing Address - Street 2:SUIT #230
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2417
Mailing Address - Country:US
Mailing Address - Phone:301-527-1510
Mailing Address - Fax:301-527-9320
Practice Address - Street 1:481 N FREDERICK AVE
Practice Address - Street 2:SUIT #230
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2417
Practice Address - Country:US
Practice Address - Phone:301-527-1510
Practice Address - Fax:301-527-9320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty