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General NPI Number Information
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NPI Number | 1255544409
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Entity Type | Organization
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Legal Business Name | HEAD,NECK & BACK PAIN CENTER P.A.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 1703 E JOPPA RD FIRST FLOOR
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City | BALTIMORE
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State | MD
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Zip | 21234-3638
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Country | US
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Telephone | 410-665-6666
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Fax | 410-882-1264
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Provider Business Mailing Address
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Address Line | 1703 E JOPPA RD FIRST FLOOR
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City | BALTIMORE
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State | MD
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Zip | 21234-3638
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Country | US
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Telephone | 410-665-6666
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Fax | 410-882-1264
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. MITCHELL ROBERT SILVERMAN
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Credential | CHIROPRACTOR
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Telephone | 410-665-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | SO1450
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License Number State | MD
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