Healthcare Provider Details

I. General information

NPI: 1407674278
Provider Name (Legal Business Name): AURASH MOKRI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AURASH AMIRMOKRI DC

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19218 MONTGOMERY VILLAGE AVE STE B-11
MONTGOMERY VILLAGE MD
20886-3700
US

IV. Provider business mailing address

18007 WHEATRIDGE DR
GERMANTOWN MD
20874-6305
US

V. Phone/Fax

Practice location:
  • Phone: 331-251-1160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS04236
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: