Healthcare Provider Details

I. General information

NPI: 1356035141
Provider Name (Legal Business Name): BLANFORD CHIROPRACTIC SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 N MAIN ST
BOONSBORO MD
21713-1017
US

IV. Provider business mailing address

28 N MAIN ST
BOONSBORO MD
21713-1017
US

V. Phone/Fax

Practice location:
  • Phone: 240-648-3030
  • Fax: 240-648-3031
Mailing address:
  • Phone: 240-648-3030
  • Fax: 240-648-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code111NT0100X
TaxonomyThermography Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES ANDREW BLANFORD
Title or Position: PRESIDENT
Credential: DC
Phone: 240-648-3030