Provider Demographics
NPI:1699983429
Name:CARROLLTON CHIROPRACTIC
Entity type:Organization
Organization Name:CARROLLTON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HEUSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-577-0023
Mailing Address - Street 1:5706 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2927
Mailing Address - Country:US
Mailing Address - Phone:301-577-0023
Mailing Address - Fax:301-577-0095
Practice Address - Street 1:5706 85TH AVE
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-2927
Practice Address - Country:US
Practice Address - Phone:301-577-0023
Practice Address - Fax:301-577-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty