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General NPI Number Information
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NPI Number | 1316489487
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Entity Type | Organization
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Legal Business Name | NEAL B. BLAXBERG D.C. , LLC
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 7 CHURCH LN SUITE 12
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City | PIKESVILLE
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State | MD
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Zip | 21208-3710
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Country | US
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Telephone | 410-484-0666
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Fax | 410-486-0816
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Provider Business Mailing Address
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Address Line | 7 CHURCH LN SUITE 12
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City | PIKESVILLE
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State | MD
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Zip | 21208-3710
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Country | US
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Telephone | 410-484-0666
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ZIPPORAH FREEDMAN
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Credential |
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Telephone | 410-484-0666
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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 | S03606
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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 | 01269
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License Number State | MD
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