Provider Demographics
NPI:1669515656
Name:BALLENGER CREEK CHIROPRACTIC INC
Entity type:Organization
Organization Name:BALLENGER CREEK CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:PALMER
Authorized Official - Last Name:STEINBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-620-1008
Mailing Address - Street 1:604 SOLAREX CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-7005
Mailing Address - Country:US
Mailing Address - Phone:301-620-1008
Mailing Address - Fax:301-620-1009
Practice Address - Street 1:604 SOLAREX CT
Practice Address - Street 2:SUITE 101
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7005
Practice Address - Country:US
Practice Address - Phone:301-620-1008
Practice Address - Fax:301-620-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD62201701OtherRENDERING
MD7335426OtherMAMSI
DCJ4730002OtherBCBS OF DC
MDPOO115547OtherIDENTIFICATION
MD185AOtherBCBS OF MARYLAND
MD185AOtherBCBS OF MARYLAND
MDU98746Medicare UPIN