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General NPI Number Information
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NPI Number | 1508015793
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Entity Type | Organization
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Legal Business Name | BLOCK CHIROPRACTIC AND REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 3901 NATIONAL DR STE 250
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1187
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Country | US
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Telephone | 301-476-7575
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Fax | 301-476-7730
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Provider Business Mailing Address
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Address Line | 3901 NATIONAL DR STE 250
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1187
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Country | US
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Telephone | 301-476-7575
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Fax | 301-476-7730
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. DEBRA M BLOCK
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Credential | D.C.
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Telephone | 301-476-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | S02149
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License Number State | MD
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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 | S02149
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License Number State | MD
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