Individual
DR. NICOLE MARIE GANGL PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
331 OAK MANOR DR STE 101, GLEN BURNIE, MD 21061-5553
(410) 766-4878
Mailing address
331 OAK MANOR DR STE 101, GLEN BURNIE, MD 21061-5553
(410) 766-4878
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S03716
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
649470000
—
MN
Enumeration date
05/17/2006
Last updated
08/01/2019
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