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Organization
JERRY L. RADAS, P.C.
Active
Organization
JERRY L. RADAS, P.C.
Active
Other names
Fulton Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY LEE RADAS D.C. (PRESIDENT)
(301) 490-8550
Entity
Organization
Contact information
Practice address
7625 MAPLE LAWN BLVD, SUITE 160, FULTON, MD 20759-2598
(301) 490-8550
(301) 490-8581
Mailing address
7625 MAPLE LAWN BLVD, SUITE 160, FULTON, MD 20759-2598
(301) 490-8550
(301) 490-8581
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
SO1592
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M123JL
CAREFIRST BCBS OF MD
—
01
—
W3530001
CAREFIRST BCBS
—
Enumeration date
08/05/2007
Last updated
01/25/2011
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