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General NPI Number Information
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NPI Number | 1518117365
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Entity Type | Organization
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Legal Business Name | KIBBY CHIROPRACTIC CENTER, PC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 2110 PRIEST BRIDGE DR SUITE 6
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City | CROFTON
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State | MD
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Zip | 21114-2472
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Country | US
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Telephone | 410-721-5050
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Fax | 301-858-1608
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Provider Business Mailing Address
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Address Line | 2110 PRIEST BRIDGE DR SUITE 6
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City | CROFTON
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State | MD
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Zip | 21114-2472
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Country | US
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Telephone | 410-721-5050
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Fax | 301-858-1608
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN F KIBBY
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Credential | D.C.
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Telephone | 410-721-5050
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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 | S01438
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License Number State | MD
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