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General NPI Number Information
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NPI Number | 1396182150
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Entity Type | Organization
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Legal Business Name | SOUTHERN MARYLAND CHIROPRACTIC CENTER DAVID E. KANE PC
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 3450 OLD WASHINGTON RD SUITE 101
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City | WALDORF
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State | MD
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Zip | 20602-3248
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Country | US
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Telephone | 301-638-7300
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Fax | 301-638-7306
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Provider Business Mailing Address
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Address Line | 3450 OLD WASHINGTON RD SUITE 101
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City | WALDORF
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State | MD
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Zip | 20602-3248
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Country | US
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Telephone | 301-638-7300
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Fax | 301-638-7306
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID EDWARD KANE
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Credential | DC
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Telephone | 301-638-7300
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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 | S01664
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License Number State | MD
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