Healthcare Provider Details

I. General information

NPI: 1770418873
Provider Name (Legal Business Name): JENNA N SORTISIO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 RITCHIE HWY STE 108
ARNOLD MD
21012-2712
US

IV. Provider business mailing address

1507 RITCHIE HWY STE 108
ARNOLD MD
21012-2712
US

V. Phone/Fax

Practice location:
  • Phone: 410-349-0000
  • Fax: 410-349-1782
Mailing address:
  • Phone: 410-349-0000
  • Fax: 410-349-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number04295
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: