Healthcare Provider Details

I. General information

NPI: 1982785127
Provider Name (Legal Business Name): WOODBINE CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 LISBON CENTER DR SUITE H
WOODBINE MD
21797-8629
US

IV. Provider business mailing address

710 LISBON CENTER DR SUITE H
WOODBINE MD
21797-8629
US

V. Phone/Fax

Practice location:
  • Phone: 301-489-9841
  • Fax: 301-624-5731
Mailing address:
  • Phone: 301-489-9841
  • Fax: 301-624-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: ALI LANKERANI
Title or Position: PARTNER
Credential: D.C.
Phone: 301-489-9841