Provider Demographics
NPI:1740339142
Name:LEE-POW, CHERYL ANN (DC)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:LEE-POW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TAFT CT STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5310
Mailing Address - Country:US
Mailing Address - Phone:301-279-9009
Mailing Address - Fax:301-279-9008
Practice Address - Street 1:4 TAFT CT STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5310
Practice Address - Country:US
Practice Address - Phone:301-279-9009
Practice Address - Fax:301-279-9008
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011353111N00000X
MDS03530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDX726-0001OtherBLUE CROSS