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General NPI Number Information
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NPI Number | 1013227859
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Entity Type | Organization
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Legal Business Name | LIBERTY MEDICAL & INJURY CENTER
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 7034 LIBERTY RD.
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City | BALTIMORE
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State | MD
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Zip | 21207
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Country | US
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Telephone | 410-580-9191
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Fax | 410-580-9393
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Provider Business Mailing Address
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Address Line | 7034 LIBERTY RD.
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City | BALTIMORE
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State | MD
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Zip | 21207
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Country | US
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Telephone | 410-580-9191
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Fax | 410-580-9393
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. ELINA MORIN
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Credential |
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Telephone | 410-580-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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