Provider Demographics
NPI:1023654290
Name:NEUBAUM WELLNESS GROUP LLC
Entity type:Organization
Organization Name:NEUBAUM WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:LEE SPARRAZZA
Authorized Official - Last Name:NEUBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-721-4155
Mailing Address - Street 1:1747 TRESTLE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-7758
Mailing Address - Country:US
Mailing Address - Phone:585-721-4155
Mailing Address - Fax:
Practice Address - Street 1:1035 EMMORTON RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5469
Practice Address - Country:US
Practice Address - Phone:410-569-5969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty