Provider Demographics
NPI:1588967251
Name:DIBLASIO, KAREN KRIS (DC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:KRIS
Last Name:DIBLASIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 N FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2458
Mailing Address - Country:US
Mailing Address - Phone:301-987-2300
Mailing Address - Fax:
Practice Address - Street 1:438 N FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2458
Practice Address - Country:US
Practice Address - Phone:301-987-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor