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Organization
MID-ATLANTIC SPINAL REHAB & CHIROPRACTIC PC
Active
Organization
MID-ATLANTIC SPINAL REHAB & CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC GREGORY GULITZ D.C. (PRESIDENT)
(443) 500-4444
Entity
Organization
Contact information
Practice address
2001 EASTERN AVE STE 1, BALTIMORE, MD 21231-3061
(443) 842-5500
(443) 842-5501
Mailing address
2001 EASTERN AVE, FIRST FLOOR, BALTIMORE, MD 21231-3061
(443) 842-5500
(443) 842-5501
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S03660
MD
225100000X
Physical Therapist
S03660
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962661405
INDIVIDUAL PROVIDER NPI
—
01
—
791518
OPTUM HEALTHCARE
—
01
—
AC670001
CAREFIRST BLUE CROSS AND BLUE SHIELD
—
Enumeration date
07/24/2012
Last updated
06/21/2021
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