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General NPI Number Information
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NPI Number | 1023741857
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Entity Type | Organization
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Legal Business Name | ESSENTIAL CHIROPRACTIC
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 07/09/2022
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Provider Practice Location Address
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Address Line | 7610 PENNSYLVANIA AVE STE 303
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City | FORESTVILLE
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State | MD
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Zip | 20747-4764
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Country | US
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Telephone | 240-838-3373
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Fax | 240-838-3475
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Provider Business Mailing Address
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Address Line | 7610 PENNSYLVANIA AVE STE 303
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City | FORESTVILLE
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State | MD
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Zip | 20747-4764
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Country | US
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Telephone | 240-838-3373
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Fax | 240-838-3475
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ALIREZA OSTOVAR
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Credential | DC
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Telephone | 240-838-3373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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