Healthcare Provider Details

I. General information

NPI: 1053996413
Provider Name (Legal Business Name): CLOVE & GINGER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-4303
US

IV. Provider business mailing address

1219 FLORIDA AVE NE SUITE 7
WASHINGTON DC
20002-7131
US

V. Phone/Fax

Practice location:
  • Phone: 202-643-5054
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: DARRIEN DRUMMOND
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 443-880-8832