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Organization
CHESTERTOWN CHIROPRACTIC CENTER LLC
Active
Organization
CHESTERTOWN CHIROPRACTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A FANNING D.C. (OWNER)
(410) 810-0530
Entity
Organization
Contact information
Practice address
819B HIGH ST, CHESTERTOWN, MD 21620-1100
(410) 810-0530
(410) 810-0200
Mailing address
819B HIGH ST, CHESTERTOWN, MD 21620-1100
(410) 810-0530
(410) 810-0200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01718
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M281
BLUECROSS BLUESHIELD
MD
01
—
S01718
LICENSE NUMBER
MD
01
—
W4570001
BLUECROSS BLUESHIELD
MD
Enumeration date
04/13/2007
Last updated
08/12/2016
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