Organization
COASTAL CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA WALLIE DC (DOCTOR/OWNER)
(410) 829-2998
Entity
Organization
Contact information
Practice address
717 GOLDSBOROUGH ST, EASTON, MD 21601-4914
(410) 829-2998
Mailing address
137 FOX DEN RD, CHURCH HILL, MD 21623-1437
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01998
MD
Other
Enumeration date
11/06/2017
Last updated
03/03/2020
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