=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437232071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHIL SALTMAN LAC DIPL AC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9199 REISTERSTOWN RD STE 203B
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-326-5481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9199 REISTERSTOWN RD STE 203B
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-326-5481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PHIL SALTMAN
-----------------------------------------------------
Credential | LAC DIPL AC
-----------------------------------------------------
Telephone | 443-326-5481
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | U01350
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------