Healthcare Provider Details

I. General information

NPI: 1861116212
Provider Name (Legal Business Name): SPECIALIZED CHIROPRACTIC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 E PULASKI HWY STE 1B
ELKTON MD
21921-6057
US

IV. Provider business mailing address

249 BARRETT RUN PL
NEWARK DE
19702-2971
US

V. Phone/Fax

Practice location:
  • Phone: 302-595-3670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AMHED AMHED
Title or Position: OWNER
Credential: BC
Phone: 404-884-3066