Provider Demographics
NPI:1881927127
Name:SPECIFIC CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:SPECIFIC CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-256-6717
Mailing Address - Street 1:12943 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:HYDES
Mailing Address - State:MD
Mailing Address - Zip Code:21082-9503
Mailing Address - Country:US
Mailing Address - Phone:410-256-6717
Mailing Address - Fax:
Practice Address - Street 1:12943 HARFORD RD
Practice Address - Street 2:
Practice Address - City:HYDES
Practice Address - State:MD
Practice Address - Zip Code:21082-9503
Practice Address - Country:US
Practice Address - Phone:410-256-6717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty