Healthcare Provider Details

I. General information

NPI: 1508864661
Provider Name (Legal Business Name): HEALING HANDS CHIROPRACTIC P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10776 GRAYS CORNER UNIT 8
BERLIN MD
21811-3561
US

IV. Provider business mailing address

10776 GRAYS CORNER UNIT 8
BERLIN MD
21811-3561
US

V. Phone/Fax

Practice location:
  • Phone: 410-629-0610
  • Fax: 410-629-0712
Mailing address:
  • Phone: 410-629-0610
  • Fax: 410-629-0712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number02053
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01994
License Number StateMD

VIII. Authorized Official

Name: DR. TRACY LYN RUSH
Title or Position: PRESIDENT
Credential: D.C.
Phone: 410-629-0610