Healthcare Provider Details

I. General information

NPI: 1649706755
Provider Name (Legal Business Name): CASHAE SPINE AND SPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 LOCKWOOD DR STE 206
SILVER SPRING MD
20901-1554
US

IV. Provider business mailing address

10800 LOCKWOOD DR SUITE 206
SILVER SPRING MD
20901-1554
US

V. Phone/Fax

Practice location:
  • Phone: 240-641-5693
  • Fax: 240-641-5702
Mailing address:
  • Phone: 240-641-5693
  • Fax: 240-641-5702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberS03626
License Number StateMD

VIII. Authorized Official

Name: DR. CASHA CHIERRE SMITH
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C
Phone: 240-641-5693