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General NPI Number Information
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NPI Number | 1538598362
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Entity Type | Organization
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Legal Business Name | CAPITAL SPORTS MEDICINE LLC
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 8630 FENTON ST SUITE 613
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City | SILVER SPRING
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State | MD
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Zip | 20910-3806
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Country | US
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Telephone | 301-328-0186
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Fax | 301-328-0266
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Provider Business Mailing Address
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Address Line | 8630 FENTON ST SUITE 613
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City | SILVER SPRING
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State | MD
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Zip | 20910-3806
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Country | US
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Telephone | 301-328-0186
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Fax | 301-328-0266
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARSON AUNE
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Credential | D.C., M.S.
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Telephone | 301-328-0186
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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 | S03675
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License Number State | MD
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