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General NPI Number Information
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NPI Number | 1013809136
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Entity Type | Organization
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Legal Business Name | ARTISAN CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 11750 BUSINESS PARK DR STE 206
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City | WALDORF
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State | MD
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Zip | 20601-2999
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Country | US
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Telephone | 240-341-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 GARDEN CITY DR STE 205
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City | HYATTSVILLE
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State | MD
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Zip | 20785-2365
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YETUNDE ONI
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Credential |
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Telephone | 240-341-0005
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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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