Provider Demographics
NPI:1952910481
Name:MID-ATLANTIC CHIROPRACTIC NORTH FREDERICK, LLC
Entity type:Organization
Organization Name:MID-ATLANTIC CHIROPRACTIC NORTH FREDERICK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHIDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-698-0001
Mailing Address - Street 1:7196 CRESTWOOD BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-1845
Mailing Address - Country:US
Mailing Address - Phone:301-698-0001
Mailing Address - Fax:
Practice Address - Street 1:2480 OSPREY WAY STE C
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-1959
Practice Address - Country:US
Practice Address - Phone:301-698-0001
Practice Address - Fax:301-698-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty