Individual
DR. PHILIP MARK DIVELBISS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
19414 LEITERSBURG PIKE, SUITE E, HAGERSTOWN, MD 21742-7601
(301) 739-2987
(301) 739-7664
Mailing address
19414 LEITERSBURG PIKE, SUITE E, HAGERSTOWN, MD 21742-7601
(301) 739-2987
(301) 739-7664
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01195
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T9550001
BLUE CHOICE MD DC
—
Enumeration date
08/12/2005
Last updated
07/08/2007
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