Provider Demographics
NPI:1982898961
Name:EFFECTIVE CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:EFFECTIVE CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:TERRELL
Authorized Official - Last Name:HARDNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-729-2200
Mailing Address - Street 1:683 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1326
Mailing Address - Country:US
Mailing Address - Phone:410-729-2200
Mailing Address - Fax:
Practice Address - Street 1:683 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1326
Practice Address - Country:US
Practice Address - Phone:410-729-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD62WCDFOtherCAREFIRST MD GROUP#
DC2201OtherCAREFIRST DC/FED GROUP#
MD566POtherMEDICARE GROUP PTAN