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General NPI Number Information
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NPI Number | 1417295171
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Entity Type | Organization
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Legal Business Name | INJURY FREE PERFORMANCE PLLC
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 3000 CONNECTICUT AVE NW SUITE 138
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City | WASHINGTON
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State | DC
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Zip | 20008-2509
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Country | US
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Telephone | 202-363-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 CONNECTICUT AVE NW SUITE 138
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City | WASHINGTON
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State | DC
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Zip | 20008-2509
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Country | US
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Telephone | 202-363-1011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL JUSTIN GLODZIK
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Credential | DC
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Telephone | 202-363-1011
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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 | CH030084
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License Number State | DC
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