Organization
JERRY L. RADAS, P.C.
Active
Other names
Fulton Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY LEE RADAS D.C. (PRESIDENT)
(301) 490-8550
Entity
Organization
Contact information
Practice address
7625 MAPLE LAWN BLVD, SUITE 160, FULTON, MD 20759-2598
(301) 490-8550
(301) 490-8581
Mailing address
7625 MAPLE LAWN BLVD, SUITE 160, FULTON, MD 20759-2598
(301) 490-8550
(301) 490-8581
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
SO1592
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M123JL
CAREFIRST BCBS OF MD
—
01
—
W3530001
CAREFIRST BCBS
—
Enumeration date
08/05/2007
Last updated
01/25/2011
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