Provider Demographics
NPI:1558597559
Name:LOVESPINE CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:LOVESPINE CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HYUNG
Authorized Official - Middle Name:HOON
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-231-7588
Mailing Address - Street 1:11820 PARKLAWN DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2529
Mailing Address - Country:US
Mailing Address - Phone:301-231-7588
Mailing Address - Fax:301-231-7587
Practice Address - Street 1:11820 PARKLAWN DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2529
Practice Address - Country:US
Practice Address - Phone:301-231-7588
Practice Address - Fax:301-231-7587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03567273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit