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Organization
MDDC, LLC
Active
Organization
MDDC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE M. YALICH D.C (PRESIDENT)
(410) 238-0140
Entity
Organization
Contact information
Practice address
3 NASHUA CT, SUITE H, BALTIMORE, MD 21221-3133
(410) 933-5678
(410) 933-3923
Mailing address
3 NASHUA CT, SUITE H, BALTIMORE, MD 21221-3133
(410) 933-5678
(410) 933-3923
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
111NX0800X
Orthopedic Chiropractor
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386898625
NPI
MD
01
—
151915
MEDICARE PTAN
MD
Enumeration date
11/13/2008
Last updated
02/28/2014
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