Organization · NPI-2

South River Family Chiropractic LLC

Clinic/Center · Edgewater, MD

NPI number1528709128
StatusActive
Last updated in NPPESApr 6, 2022

Details

NPI
1528709128
Entity type
Organization (NPI-2)
Legal business name
South River Family Chiropractic LLC
Organization subpart
No
Enumeration date
Apr 6, 2022
Certification date
Apr 6, 2022
Last updated
Apr 6, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

3168 Braverton St Ste 302
Edgewater, MD 21037-2680

Phone 410-353-1616

Mailing address

1406 James Way
Edgewater, MD 21037-1713

Phone 410-353-1616

Authorized official

Angela Carlynn Tarjick
Owner/Chiropractor
4103531616

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