Healthcare Provider Details

I. General information

NPI: 1588557953
Provider Name (Legal Business Name): CLARENCE WROBLEWSKI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 THOMAS JOHNSON DR STE 12
FREDERICK MD
21702-4456
US

IV. Provider business mailing address

198 THOMAS JOHNSON DR STE 12
FREDERICK MD
21702-4456
US

V. Phone/Fax

Practice location:
  • Phone: 301-696-8888
  • Fax:
Mailing address:
  • Phone: 301-696-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS04259
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberS04259
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberS04259
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberS04259
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberS04259
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberS04259
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberS04259
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberS04259
License Number StateMD
# 9
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberS04259
License Number StateMD
# 10
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberS04259
License Number StateMD
# 11
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberS04259
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: