Organization
MARYLAND SPINE REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS S CRIVELLI II D.C., M.S., C.N.S. (OWNER)
(301) 652-7717
Entity
Organization
Contact information
Practice address
1515 MERRITT BLVD, DUNDALK, MD 21222-2113
(410) 285-0920
Mailing address
PO BOX 745854, ATLANTA, GA 30374-5854
(410) 970-8190
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
111NN1001X
Nutrition Chiropractor
—
—
Other
Enumeration date
12/11/2007
Last updated
01/20/2021
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