Organization
HOWARD COUNTY CHIROPRACTIC SPINE & SPORTS REHABILITATION. LLC
Active
Organization
HOWARD COUNTY CHIROPRACTIC SPINE & SPORTS REHABILITATION. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSEL VINCENT ANTICO D.C., CCSP (OWNER)
(443) 259-0235
Entity
Organization
Contact information
Practice address
8894 STANFORD BLVD, SUITE I02, COLUMBIA, MD 21045-4794
(443) 259-0235
(443) 259-0236
Mailing address
8894 STANFORD BLVD, SUITE I02, COLUMBIA, MD 21045-4794
(443) 259-0235
(443) 259-0236
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
S01939
MD
Other
Enumeration date
04/16/2007
Last updated
01/17/2013
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