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General NPI Number Information
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NPI Number | 1790195238
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Entity Type | Organization
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Legal Business Name | ROLAND PARK CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 05/03/2018
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Provider Practice Location Address
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Address Line | 6301 N CHARLES ST STE 1
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City | BALTIMORE
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State | MD
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Zip | 21212-1040
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Country | US
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Telephone | 443-841-7817
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Fax | 443-815-4778
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Provider Business Mailing Address
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Address Line | 6307 BOXWOOD RD
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City | BALTIMORE
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State | MD
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Zip | 21212-2211
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Country | US
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Telephone | 971-238-9670
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Fax | 443-815-4778
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Authorized Official
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Title or Position | MANGER/MEMBER
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Name | DR. SILKE LAUB
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Credential | D.C.
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Telephone | 503-380-6897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5560
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | C16813
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License Number State | MD
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