Organization
COLUMBIA ADVANCED CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN M MANISON D.C. (MANAGING MEMBER LLC)
(410) 964-3229
Entity
Organization
Contact information
Practice address
8835 COLUMBIA 100 PKWY, SUITE D, COLUMBIA, MD 21045-2147
(410) 964-3229
(410) 964-9671
Mailing address
8835 COLUMBIA 100 PKWY, SUITE D, COLUMBIA, MD 21045-2147
(410) 964-3229
(410) 964-9671
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1898PT
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215131
MEDICARE PTAN
MD
Enumeration date
02/22/2007
Last updated
10/10/2012
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