Healthcare Provider Details

I. General information

NPI: 1457086746
Provider Name (Legal Business Name): COREY TIMBERS L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 01/25/2023
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 GEORGIA AVE STE 300
SILVER SPRING MD
20910-3614
US

IV. Provider business mailing address

2715 DANIEL RD
CHEVY CHASE MD
20815-3150
US

V. Phone/Fax

Practice location:
  • Phone: 240-449-8221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU02772
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: