Provider Demographics
NPI:1124809561
Name:NORTH BETHESDA CHIROPRACTIC AND PHYSICAL HEALTH
Entity type:Organization
Organization Name:NORTH BETHESDA CHIROPRACTIC AND PHYSICAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-308-1380
Mailing Address - Street 1:11018 SHALOM LN
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-4033
Mailing Address - Country:US
Mailing Address - Phone:203-308-1380
Mailing Address - Fax:
Practice Address - Street 1:5206 NICHOLSON LN
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1045
Practice Address - Country:US
Practice Address - Phone:203-308-1380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty