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General NPI Number Information
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NPI Number | 1013257120
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Entity Type | Organization
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Legal Business Name | GREEN LIFE CHIROPRACTIC & WELLNESS, LLC
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 45 OLD SOLOMONS ISLAND RD SUITE 102
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3858
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Country | US
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Telephone | 410-224-4348
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Fax | 410-224-4732
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Provider Business Mailing Address
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Address Line | 45 OLD SOLOMONS ISLAND RD SUITE 102
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3858
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Country | US
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Telephone | 410-224-4348
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Fax | 410-224-4732
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Authorized Official
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Title or Position | OWNER
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Name | MISS MARY ELIZABETH STEELE
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Credential | D.C.
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Telephone | 410-224-4348
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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 | 03710
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 03711
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License Number State | MD
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