Healthcare Provider Details

I. General information

NPI: 1144355801
Provider Name (Legal Business Name): COLUMBIA CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 TWIN KNOLLS RD SUITE 321
COLUMBIA MD
21045-3266
US

IV. Provider business mailing address

5525 TWIN KNOLLS ROAD SUITE 321
COLUMBIA MD
21045
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-7776
  • Fax:
Mailing address:
  • Phone: 410-997-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1431
License Number StateMD

VIII. Authorized Official

Name: PAUL J BARLOW
Title or Position: OWNER
Credential: DC
Phone: 410-997-7776