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Organization

CHESTERTOWN CHIROPRACTIC CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA A FANNING D.C. (OWNER)
(410) 810-0530
Entity
Organization

Contact information

Practice address
819B HIGH ST, CHESTERTOWN, MD 21620-1100
(410) 810-0530
(410) 810-0200
Mailing address
819B HIGH ST, CHESTERTOWN, MD 21620-1100
(410) 810-0530
(410) 810-0200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01718
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M281
BLUECROSS BLUESHIELD
MD
01
S01718
LICENSE NUMBER
MD
01
W4570001
BLUECROSS BLUESHIELD
MD
Enumeration date
04/13/2007
Last updated
08/12/2016
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