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General NPI Number Information
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NPI Number | 1871632117
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Entity Type | Individual
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Provider Name | ETHAN MILES KIRCHNER D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 508 ROCK SPRING AVE. STE 100
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City | BEL AIR
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State | MD
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Zip | 21014
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Country | US
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Telephone | 410-836-0001
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Fax | 410-893-6373
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Provider Business Mailing Address
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Address Line | 2206 LAFAYETTE RD STE 100
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1043
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Country | US
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Telephone | 765-362-0123
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Fax | 765-362-8479
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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 | S02127
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License Number State | MD
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