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General NPI Number Information
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NPI Number | 1639798259
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Entity Type | Organization
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Legal Business Name | ATLANTIC RELIABLE CARE, LLC
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 2401 LIBERTY HEIGHTS AVE STE 1020
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City | BALTIMORE
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State | MD
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Zip | 21215-8019
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Country | US
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Telephone | 410-728-0396
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Fax | 410-728-0398
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Provider Business Mailing Address
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Address Line | PO BOX 245
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City | REISTERSTOWN
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State | MD
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Zip | 21136-0245
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Country | US
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Telephone | 410-728-0396
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Fax | 410-728-0398
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Authorized Official
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Title or Position | MANAGER
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Name | YEVGENIY KALISH
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Credential |
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Telephone | 410-728-0396
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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 |
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License Number State |
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