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General NPI Number Information
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NPI Number | 1457088122
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE INTEGRATIVE HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 65 DUKE ST STE 107
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-6128
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Country | US
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Telephone | 443-532-8331
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Fax |
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Provider Business Mailing Address
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Address Line | 134 CALVERT TOWNE RD
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4100
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Country | US
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Telephone | 443-532-8331
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Fax |
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Authorized Official
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Title or Position | RDH, OMT
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Name | ERIKA KAINE BOTTALICO
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Credential | RDH
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Telephone | 443-532-8331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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