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Organization

BERRY CHIROPRACTIC CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD BLAKE BERRY DC (OWNER)
(301) 620-4100
Entity
Organization

Contact information

Practice address
176 THOMAS JOHNSON DR, #204, FREDERICK, MD 21702-4410
(301) 620-4100
(301) 420-1407
Mailing address
176 THOMAS JOHNSON DR, #204, FREDERICK, MD 21702-4410
(301) 620-4100

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
S01420
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
223239
MAMSI
01
3831919
CIGNA
01
KP25BE
CAREFIRST BCBS MARYLAND
01
W375-0001
CAREFIRST BCBS FEP
Enumeration date
12/03/2007
Last updated
03/06/2012
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