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General NPI Number Information
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NPI Number | 1619915618
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE CHIROPRACTIC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 7954 BALTIMORE ANNAPOLIS BLVD SUITE 2K
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City | GLEN BURNIE
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State | MD
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Zip | 21060-8188
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Country | US
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Telephone | 410-760-7722
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Fax | 410-760-3939
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Provider Business Mailing Address
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Address Line | 7954 BALTIMORE ANNAPOLIS BLVD SUITE2K
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City | GLEN BURNIE
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State | MD
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Zip | 21060-8188
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Country | US
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Telephone | 410-760-7722
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW J DELSIGNORE
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Credential | CH
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Telephone | 410-760-7722
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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 | 03459
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License Number State | MD
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