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General NPI Number Information
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NPI Number | 1508080797
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Entity Type | Organization
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Legal Business Name | ADVANCED SPINAL CARE & REHABILITATION INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 9515 DEERECO RD SUITE 305
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City | TIMONIUM
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State | MD
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Zip | 21093-2116
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Country | US
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Telephone | 410-252-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 9515 DEERECO RD SUITE 305
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City | TIMONIUM
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State | MD
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Zip | 21093-2116
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL DAIUTO SR.
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Credential | D.C.
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Telephone | 410-252-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | S01893
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License Number State | MD
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