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General NPI Number Information
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NPI Number | 1487726436
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Entity Type | Organization
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Legal Business Name | YALICH CLINIC OF SALISBURY
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 1319 MT HERMON ROAD YALICH CLINIC OF SALISBURY
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City | SALISBURY
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State | MD
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Zip | 21804
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Country | US
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Telephone | 410-548-1500
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Fax | 410-548-1614
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Provider Business Mailing Address
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Address Line | 1319 MT HERMON ROAD YALICH CLINIC OF SALISBURY
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City | SALISBURY
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State | MD
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Zip | 21804
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Country | US
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Telephone | 410-548-1500
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Fax | 410-548-1614
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN LAWRENCE GRANT SR.
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Credential | DC
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Telephone | 410-548-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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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 | 01397
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License Number State | MD
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