Organization
CHIROPRACTIC WELLNESS CENTER OF BALTIMORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ANDREW ROEDER DC (OWNER)
(410) 529-8010
Entity
Organization
Contact information
Practice address
8723 BELAIR RD, BALTIMORE, MD 21236-2419
(410) 529-8010
(410) 529-8424
Mailing address
8723 BELAIR RD, BALTIMORE, MD 21236-2419
(410) 529-8010
(410) 529-8424
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
02080
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400455800
—
MD
01
—
61706801
BLUE CROSS
MD
01
—
G911
BLUE CROSS PROVIDER
—
01
—
KCZ8CH
BLUE CROSS PROVIDER
MD
Enumeration date
07/24/2007
Last updated
07/24/2012
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