MEDICARE: NATIONAL CHIROPRACTIC &SPORTS REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1649900507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL CHIROPRACTIC &SPORTS REHABILITATION

Provider Business Mailing Address
First Line	:	9501 OLD ANNAPOLIS RD STE 301
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6337
Country	:	US
Telephone Number	:	410-531-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 OLD ANNAPOLIS RD STE 301
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6337
Country	:	US
Telephone Number	:	443-605-2214
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. FELICIA LEIPOLD
Credential	:	DC, ATC
Telephone Number	:	410-531-8000

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	01/23/2024

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