Healthcare Provider Details

I. General information

NPI: 1922417864
Provider Name (Legal Business Name): JULIE SCANLON D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 FERNDALE RD
GLEN BURNIE MD
21061-2437
US

IV. Provider business mailing address

175 ADMIRAL COCHRANE DR STE 204
ANNAPOLIS MD
21401-7419
US

V. Phone/Fax

Practice location:
  • Phone: 443-618-3912
  • Fax:
Mailing address:
  • Phone: 443-433-0590
  • Fax: 443-433-0591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF1-0000886
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010859
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS03795
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: