Provider Demographics
NPI:1720614761
Name:AMBER MEADOWS CHIROPRACTIC
Entity Type:Organization
Organization Name:AMBER MEADOWS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BISSET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-663-8707
Mailing Address - Street 1:286 MONTEVUE LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-8212
Mailing Address - Country:US
Mailing Address - Phone:301-663-8707
Mailing Address - Fax:
Practice Address - Street 1:286 MONTEVUE LN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-8212
Practice Address - Country:US
Practice Address - Phone:301-663-8707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-22
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty