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General NPI Number Information
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NPI Number | 1154801470
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Entity Type | Organization
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Legal Business Name | MARYLAND FARMS CHIROPRACTIC, INC
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 5107 MARYLAND WAY STE 110
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City | BRENTWOOD
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State | TN
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Zip | 37027-7565
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Country | US
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Telephone | 615-309-8279
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Fax | 615-309-8298
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Provider Business Mailing Address
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Address Line | 5107 MARYLAND WAY STE 110
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City | BRENTWOOD
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State | TN
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Zip | 37027-7565
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Country | US
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Telephone | 615-309-8279
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Fax | 615-309-8298
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH BAKER
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Credential | DC
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Telephone | 615-309-8279
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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 | 2452
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License Number State | TN
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