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General NPI Number Information
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NPI Number | 1790795334
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Entity Type | Individual
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Provider Name | JARROD BLAIRE LIPPY D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 516 N CHARLES ST
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City | BALTIMORE
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State | MD
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Zip | 21201-5021
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Country | US
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Telephone | 410-347-3590
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Fax | 410-347-3592
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Provider Business Mailing Address
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Address Line | 901 MAIDEN CHOICE LN
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City | BALTIMORE
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State | MD
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Zip | 21229-4840
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Country | US
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Telephone | 443-983-1987
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 02161S
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License Number State | MD
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