Provider Demographics
NPI:1508864661
Name:HEALING HANDS CHIROPRACTIC P C
Entity Type:Organization
Organization Name:HEALING HANDS CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-629-0610
Mailing Address - Street 1:10776 GRAYS CORNER
Mailing Address - Street 2:UNIT 8
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3561
Mailing Address - Country:US
Mailing Address - Phone:410-629-0610
Mailing Address - Fax:410-629-0712
Practice Address - Street 1:10776 GRAYS CORNER
Practice Address - Street 2:UNIT 8
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-3561
Practice Address - Country:US
Practice Address - Phone:410-629-0610
Practice Address - Fax:410-629-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01994111N00000X
MD02053111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD347MMedicare PIN