Provider Demographics
NPI:1750895967
Name:KASHI CHESAPEAKE CHIROPRACTIC AND SPINAL REHAB, PC
Entity type:Organization
Organization Name:KASHI CHESAPEAKE CHIROPRACTIC AND SPINAL REHAB, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYKAVOOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:571-643-1000
Mailing Address - Street 1:1211 S CONKLING ST APT 605
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5351
Mailing Address - Country:US
Mailing Address - Phone:571-643-1000
Mailing Address - Fax:
Practice Address - Street 1:1103 N POINT BLVD STE 404
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3486
Practice Address - Country:US
Practice Address - Phone:410-285-2600
Practice Address - Fax:410-285-4942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty