Healthcare Provider Details

I. General information

NPI: 1578134649
Provider Name (Legal Business Name): MI VENTURES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7411 RIGGS RD STE 208
ADELPHI MD
20783-4246
US

IV. Provider business mailing address

7411 RIGGS RD STE 208
ADELPHI MD
20783-4246
US

V. Phone/Fax

Practice location:
  • Phone: 301-439-0381
  • Fax: 301-439-0383
Mailing address:
  • Phone: 301-439-0381
  • Fax: 301-439-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE WILLIAMS
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 301-439-0381